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CBO Membership Application
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Membership Application
*
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Primary #1
*
First Name
*
Last Name
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Date of Birth
*
Address
*
City
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*
Zip
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Mobile Phone #
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Are you Jewish?
Please Select One
Yes
No
Mother's Hebrew Name
Father's Hebrew Name
Tribe (if not known type N/A)
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Primary #2
*
First Name
*
Last Name
Hebrew Name
Date of Birth
Address
City
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
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Indiana
Iowa
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Maryland
Massachusetts
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Tennessee
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Utah
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Washington
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Zip
Home Phone #
Mobile Phone #
*
Email Address
*
Are you Jewish?
Please Select One
Yes
No
Mother's Hebrew Name
Father's Hebrew Name
Tribe (if not known type N/A)
Occupation
Business Phone #
Can you read Hebrew?
Number of Children
Please Select
I do not have children
ONE
TWO
THREE
FOUR
*If child was adopted and birth mother was not Jewish, or if either spouse converted to Judaism, please provide conversion documents.
Child #1 Information
*
First Name
Gender
N/A or Unknown
Male
Female
Date of Birth
Child's Hebrew Name
Name of School
Grade
Do you want to enroll this child in Hebrew School?
No
Yes
Grades: Kindergarten through High School
Do you want to enroll this child in our Early Childhood Program?
No
Yes
This program is for 5 month to 4 year old children.
*
Please select a time slot for your child.
Thursday, 6:00 PM
Saturday, 11:15 AM
Sunday, 11:15 AM
Unsure
Child # 2 Information
*
First Name
Gender
N/A or Unknown
Male
Female
Date of Birth
Child's Hebrew Name
Name of School
Grade
Do you want to enroll this child in Hebrew School?
No
Yes
Grades: Kindergarten through High School
Do you want to enroll this child in our Early Childhood Program?
No
Yes
This program is for 5 month to 4 year old children.
*
Please select a time slot for your child.
Thursday, 6:00 PM
Saturday, 11:15 AM
Sunday, 11:15 AM
Unsure
Child # 3 Information
*
First Name
Gender
N/A or Unknown
Male
Female
Date of Birth
Child's Hebrew Name
Name of School
Grade
Do you want to enroll this child in Hebrew School?
No
Yes
Grades: Kindergarten through High School
Do you want to enroll this child in our Early Childhood Program?
No
Yes
This program is for 5 month to 4 year old children.
*
Please select a time slot for your child.
Thursday, 6:00 PM
Saturday, 11:15 AM
Sunday, 11:15 AM
Unsure
Child # 4 Information
*
First Name
Gender
N/A or Unknown
Male
Female
Date of Birth
Child's Hebrew Name
Name of School
Grade
Do you want to enroll this child in Hebrew School?
No
Yes
Grades: Kindergarten through High School
Do you want to enroll this child in our Early Childhood Program?
No
Yes
This program is for 5 month to 4 year old children.
*
Please select a time slot for your child.
Thursday, 6:00 PM
Saturday, 11:15 AM
Sunday, 11:15 AM
Unsure
Please answer a few questions below, we would love to get to know you!
-
Thank you for joining! What made you decide to join our CBO family?
If you have any relatives that are currently members of the CBO, please list names and relationships:
How did you hear about CBO?
What are you looking for in being a member of the CBO family?
Is there anything you would like us to know about you/your family?
*
Please check the box.
I, HEREBY MAKE APPLICATION FOR MEMBERSHIP IN CONGREGATION BETH OHR AND AGREES TO ALL FINANCIAL TERMS AND CONDITIONS OF MEMBERSHIP.
In consideration of my/our membership in Congregation Beth Ohr, I/we agree to pay all charges for dues, building and other funds, tuition, Bar/Bat Mitzvah fees and assessments upon receipt of regular statements apprising me/us of such. Any payment arrangements other than those detailed above must be made in advance and can be agreed to only by the Finance Committee. I/we understand that no High Holiday tickets will be distributed or students admitted to Sunday/Hebrew School unless my/our account is current. I/we further agree that, as a sustaining member of Congregation Beth Ohr, my/our membership and the terms of payment elected in this agreement shall continue in perpetuity until cancelled. Congregation Beth Ohr shall provide me/us with a statement reflecting the coming year’s charges after establishment pursuant to the rules and procedures and shall charge my/our cards/accounts (if applicable) in accordance with my/our election. I/we understand that I/we may cancel my/our membership at any time prior to issuance of my/our High Holiday tickets and my/our account shall be billed or refunded as applicable for all charges accrued pro rata from July 1 to the date of cancellation. I/we further understand that after I/we have received my/our High Holiday tickets, no cancellation for the current fiscal year is possible. All balances that are past-due shall incur a late charge equal to 1% per month on the outstanding balance. Further, in the event that any balance remains unpaid, we reserve the right to retain and attorney to engage in collection of said balance. In that event you will be responsible for all reasonable legal fees incurred in this collection activity. Your use of the services offered by Congregation Beth Ohr shall be deemed your acceptance of these terms and conditions. All payments are applied to satisfy arrearages in preference over current obligations. Congregation Beth Ohr has my permission to use my or my child’s photograph. I understand that the images may be used in print publications, online publications, presentations, websites, and social media only published on Congregation Beth Ohr materials and accounts. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
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Please note that once your account is set up, you will receive an email to set up a password and you will be able to view your account, pay your balance, and add Yahrzeits to your account.
Wed, December 4 2024 3 Kislev 5785