TBIWaltham Membership Application

  • Membership Information

  • Please tell us about you and your family and how you would like us to contact you. 

    Please DO NOT use all caps when completing this form. 

    • About You and Your Family 
    • Adult #1 Information 
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    • Adult #1 Birth Date
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    • Adult #1 How should we call you up for an Aliyah?
    • Photograph Release Form I, hereby grant permission to Temple Beth Israel to use any photos that have been taken of me for the purpose of SELF USE and or SELF PROMOTION publications which can include but is not limited to, advertising, fliers, newsletters and websites without any compensation or recognition given to me. Furthermore, I grant creative permission to alter the photograph(s). I do not grant permission to resale or use the photographs in a manner that would exploit or cause malicious representation toward me. At any time I can change my decision by submitting a request in writing to Temple Beth Israel, 25 Harvard Street, Waltham, MA 02453.*
    • Adult #2 Information 
    •  -
    • Adult #2 Birthdate
       - -
    • Adult #2: How should we call you up for an ailyah?
    • Wedding Anniversary Date
       - -
    • Photograph Release Form I, hereby grant permission to Temple Beth Israel to use any photos that have been taken of me for the purpose of SELF USE and or SELF PROMOTION publications which can include but is not limited to, advertising, fliers, newsletters and websites without any compensation or recognition given to me. Furthermore, I grant creative permission to alter the photograph(s). I do not grant permission to resale or use the photographs in a manner that would exploit or cause malicious representation toward me. At any time I can change my decision by submitting a request in writing to Temple Beth Israel, 25 Harvard Street, Waltham, MA 02453.
    • Children 
  •  -
    • Emergency Contact Information 
    • Contact Preferences 
    • Rows
    • Yahrzeits 

    • We will list the names of those you remember in the Temple Bulletin and on the Memorial Wall in the sanctuary during the hebrew month of their Yahrzeit. 

      If you are a current member who has provided this information previously, and have no updates, you do not need to enter it again.

    • Getting Involved 
    • Membership and Contributions  

    • The recommended sustaining membership contribution is $1,000 per individual, $2,000 per family.  Please give at this level if you are able, and more if you can. If this amount is beyond your means, please specify an amount to pledge or call the office to arrange payment plan. All are welcome. 

       

      If you will be paying by credit card, please add $30/individual or $60/family contribution to defray the credit card fees. 

       

    • To submit this form... 

    • Thank you for completing this membership form. Now you can either pay with a credit card below, or you can mail a check to Temple Beth Israel, 25 Harvard Street, Waltham, MA 02453.

    • Payment Options 

    • Payment Options:

      • To pay by check: click SUBMIT and then send your payment to Temple Beth Israel, 25 Harvard Street, Waltham, MA 02453
      • To pay by credit card (please add a 3% convenience fee) SUBMIT this form and then navigate to the Temple Website 
      1. pay in full at: http://www.tbiwaltham.org/engage/become-a-member/
      2. pay an alternate amount at our Donate page http://www.tbiwaltham.org/give/donate-online/

       

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