CBE Membership Application

* HOME ADDRESS LINE 1

HOME ADDRESS LINE 2

* CITY

STATE

* ZIP

* MARITAL STATUS

ANNIVERSARY (IF APPLICABLE)

TRIBE

THIS SECTION IS FOR HEAD OF HOUSEHOLD

* FIRST NAME

* LAST NAME

MAIDEN NAME (IF APPLICABLE)

HEBREW NAME (PLEASE USE TRANSLITERATION)

GENDER

* BIRTHDATE

Choose One for Head of Household:

Jewish by BirthJewish by ChoiceNon-Jew

* EMAIL

CELL PHONE

OCCUPATION

THIS SECTION IS FOR ADULT #2 (IF APPLICABLE)

FIRST NAME

LAST NAME

MAIDEN NAME (IF APPLICABLE)

HEBREW NAME (PLEASE USE TRANSLITERATION)

GENDER

BIRTHDATE

Choose One for Adult #2:

Jewish by BirthJewish by ChoiceNon-Jew

CELL PHONE

OCCUPATION

THIS SECTION IS FOR CHILDREN LIVING IN THE HOME (IF APPLICABLE)

FIRST NAME CHILD 1

LAST NAME CHILD 1

BIRTHDATE CHILD 1

GRADE CHILD 1

GENDER CHILD 1

FIRST NAME CHILD 2

LAST NAME CHILD 2

BIRTHDATE CHILD 2

GRADE CHILD 2

GENDER CHILD 2

FIRST NAME CHILD 3

LAST NAME CHILD 3

BIRTHDATE CHILD 3

GRADE CHILD 3

GENDER CHILD 3

PLEASE LIST YAHRZEITS HERE.
If you have more than 4 observances, please email the additional names and dates to admin@betheltx.org.

Name of Deceased

Name and Relationshp of Mourner/Observer

EX. mother of Jane Doe

Date of Death

Ex. 01/01/2001

English Date Observance

YES, I observe the English date of deathNO, please convert to the Jewish date

Name of Deceased

Name and Relationshp of Mourner/Observer

EX. mother of Jane Doe

Date of Death

Ex. 01/01/2001

English Date Observance

YES, I observe the English date of deathNO, please convert to the Jewish date

Name of Deceased

Name and Relationshp of Mourner/Observer

EX. mother of Jane Doe

Date of Death

Ex. 01/01/2001

English Date Observance

YES, I observe the English date of deathNO, please convert to the Jewish date

Name of Deceased

Name and Relationshp of Mourner/Observer

EX. mother of Jane Doe

Date of Death

Ex. 01/01/2001

English Date Observance

YES, I observe the English date of deathNO, please convert to the Jewish date

CBE 2024-2025 Dues Commitment

Please review the commitment options below, select the appropriate level, and write in your commitment pledge. The suggested range is 2.5% of a member family’s gross income.

Please note that High Holy Day tickets ARE included. B’nai Mitzvah fees and Religious School are not included.

The $118 URJ Membership Fee, the Facilities Maintenance Fee of $175, and the Security Fee of $100 are not included in the below chart. These fees will be billed within the first 90 days of joining Beth El.

* Dues Commitment

* I would like to pay my dues

Please Select OneMonthlyQuarterlyYearly

CONGREGATION BETH EL