FCSI Membership Form
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Your Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birthday
-
Month
-
Day
Year
Date
Your Hebrew Name (if known)
Your Occupation
Your marital status
*
Please Select
Married
Single
Life Partner
Widow/Widower
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Your wedding anniversary, if applicable
-
Month
-
Day
Year
Date
Please answer these questions about your spouse or partner.
*
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Do you have children living at home with you?
*
No
Yes
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Child #1
Child #2
Child #3
Child #4
Child #5
Are you interested in religious school for your children at this time?
Yes
No
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How would you like to receive congregation communications?
*
Online only
Online and Postal Mail
Each year we publish a membership directory shared with current members only. Please check all you would like shared in future annual directories.
*
Name
Address
Phone Number
Email Address
My Child/Children(s) Names
You can share all in the member directory
I give permission for images or video of myself and family members taken at religious or social events to be used in FCSI promotional material including social media, website, e-newsletter, other media. We do not identify by name or tag individuals.)
*
Yes
No
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My membership level
*
Annual Family Membership ($1172.00)
Annual Individual Membership ($624.00)
Annual Associate Membership ($513.00)
I will pay my dues (method):
*
Online (Credit card, EFT, digital wallet)
Check
I will pay my dues (frequency):
*
Annually (recommended): Payment due on Sept 15
Semi-annually: Payments due on Sept 15 and March 15
Quarterly: Payments due on the 15th of Sept, Dec, March and June
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