TEFILAT YAMIM - Member Information Form

בס״ד
TEFILAT YAMIM - תפילת ימים

Ir Yamim, Netanya / info@tefilatyamim.org / 053.594.0997
MEMBERSHIP FORM

New Member or Renewal

2025-2026 / 5786 - תשפ״ו
Is this a membership renewal or a first-time registration? Please choose one.*

RenewalFirst-time
Thank you for becoming Members of our wonderful community. Please take just a few minutes to help us best serve you and your family by completing this form. The information you provide will be kept confidential & only for our records.
Thank you for renewing your Membership. If you have any questions, please WhatsApp Rami @ +972546742284.
Who is this renewal for?*

For my spouse and meFor me only
I want to update the following*
Enter your update in the space below.
Enter your updates here
Submit any additional info and we will contact you if clarification is required.
Your FIRST Name (English)*
Your FAMILY Name (English)*
Your E-Mail*
Your Phone Number*
Please enter a valid phone number.
FAMILY NAME (Hebrew)
ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal Code
Please Select (M/F)*
Please Choose One to Help us With an Aliya L'Torah

Kohen (כהן)Levi (לוי)Yisroel (ישראל)
Please Complete to Help us With an Aliya L'Torah
HEBREW Name as Called up to the Torah (פלוני בן פלוני). Can answer in English
What is your Bar Mitzva Parsha?
Can answer in English
I would be interested in participating during Tefila (Choose all that apply)

Lain the TorahDaven for AmudRead the HaftorahGive Dvar TorahGive Shiur after TefilaRead MegillaGabbai
Please indicate whether or not this is a single membership form or if you need to enter information for a spouse*
Spouse FIRST Name*
Spouse FAMILY Name if not same as yours
Spouse E-Mail*
Spouse Phone*
Please enter a valid phone number.
Please Choose One to Help us With an Aliya L'Torah for your Spouse

Kohen (כהן)Levi (לוי)Yisroel (ישראל)
Please Complete to Help us With an Aliya L'Torah for your Spouse
HEBREW Name as Called up to the Torah (פלוני בן פלוני). Can answer in English
What is your Spouse's Bar Mitzva Parsha?
Can answer in English
My spouse would be interested in participating during Tefila (Choose all that apply)

Lain the TorahDaven for AmudRead the HaftorahGive Dvar TorahGive Shiur after TefilaRead MegillaGabbai
# Children Living at Home*
Child #1*
Child #2*
Child #3*
Child #4*
Child #5*
Please indicate whether or not you need to enter Yahrtzeit information*
How many total Yahrtzeits would you or your spouse like to list?*
Yahrtzeit #1*
Yahrtzeit #2*
Yahrtzeit #3*
Yahrtzeit #4*
Yahrtzeit #5*
Yahrtzeit #6*
Yahrtzeit #7*
I or a family member would be interested in joining a committee (Choose all that apply)

KiddishChild EducationAdult EducationChessedFundraisingOther (answer pop-up below)
Please help us by suggesting what "other" committee you'd be interested in forming or joining
Is there anything else you would like us to know or do you have any comments or suggestions?
* Membership dues are ₪2,000 per family *
Here are the various payment options to receive a tax receipt:

If you can not pay in full or prefer to pay over time, you will not be turned away, and we will work with you confidentially to make special arrangements.
From where and how would you like a tax receipt? *
This may open another window for payment - please make sure you complete this form in this window as well by also clicking SUBMIT below. Thank you very much.
CLICK for USA CREDIT CARD - option 2
CLICK for ISRAEL CREDIT CARD/BIT - option 1
CLICK for CAD/GBP CREDIT CARD
ISRAEL Bank Transfer:

Mizrachi Bank (#20)

Branch #423

Account # 315794

"Tefilat Yamim"
USA Check/Bank Transfer:

Call/WhatsApp Rami for details.

+972546742284
Call/WhatsApp Rami for details.

+972546742284
Join our ANNOUNCEMENT & INFO WhatsApp group: TY-Announcements-Info-Group

Join our COMMUNITY CHAT WhatsApp group: TY-Community-Chat-Group

Join our SISTERHOOD WhatsApp Group: TY-Sisterhood-Group

E-Mail: info@tefilatyamim.org

Rav Mendel: 053.8809063 / ravmendel@tefilatyamim.org

For any questions or looking to volunteer, please WhatsApp or call

Jonathan (053.8236143) or Rami (054.6742284)

Thank you for completing the form.
Should be Empty:

TEFILAT YAMIM - תפילת ימים

Thank you for becoming Members of our wonderful community. Please take just a few minutes to help us best serve you and your family by completing this form. The information you provide will be kept confidential & only for our records.

Thank you for renewing your Membership. If you have any questions, please WhatsApp Rami @ +972546742284.