AA Membership Application

Membership Application

Welcome to Ahavath Achim Synagogue!
Ahavath Achim Synagogue is a historical, egalitarian congregation driven by Social Action, Jewish Continuity and Cultural Arts and Education. These focal points are the guiding forces in our community and serve as an invitation to all people who want to participate. In our 130th year, we are one of the oldest Synagogues in the Conservative movement.

In addition to offering a wide variety of spiritual experiences and worship opportunities within our congregation, we also have a dynamic Reggio Emilia Inspired preschool, Ahava Early Learning Center, that offers top-notch care and learning in a warm, welcoming and nurturing environment.

Friendly and inclusive, AA is a diverse community made up of caring and engaging clergy, dedicated and creative staff, enthusiastic lay leaders, and committed congregants - all extending a warm welcome to you.

Whether you’re one of our energetic young families just getting involved, an old-timer rooted in founding generations with stories to tell, or even someone who’s still searching for the place that fits, you can feel at home at AA.

Be an active part of our multi-generational community. Be spiritually uplifted, socially involved, and intellectually stimulated - come be family.

If you have questions, please contact Miriam Habif at mhabif@aasynagogue.org or 404.603.5749.
How many adults are you registering? *
Adult 1
Title: *
Full name: *

First Name Last Name
Alternate name or nickname?
Hebrew name (if applicable):
Full Hebrew name: ben/bat followed by father's full Hebrew name (ben is 'son of' and bat is 'daughter of').
Email: *
example@example.com
Cell phone: *
Home phone:
Work phone:

Date of birth: *

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Gender: *
Marital status: *
Date of marriage (if applicable):

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Occupation: *
Current religion: *
If you are Jewish by choice, please indicate your conversion date:

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Bar/Bat Mitzvah date:

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Please indicate if you belong to one of these groups:

Kohen Levite Israelite
Do you have any relatives that are members? If yes, please name them, and tell us your relation to them:
Adult 2
Title: *
Full name: *

First Name Last Name
Alternate name or nickname?
Hebrew name (if applicable):
Full Hebrew name: ben/bat followed by father's full Hebrew name (ben is 'son of' and bat is 'daughter of').
Email: *
example@example.com
Cell phone: *
Home phone:
Work phone:

Date of birth: *

Month Day Year Date Picker Icon
Gender: *
Marital status: *
Date of marriage (if applicable):

Month Day Year Date Picker Icon
Occupation: *
Current religion: *
If you are Jewish by choice, please indicate your conversion date:

Month Day Year Date Picker Icon
Bar/Bat Mitzvah date:

Month Day Year Date Picker Icon
Please indicate if you belong to one of these groups:

Kohen Levite Israelite
Do you have any relatives that are members? If yes, please name them, and tell us your relation to them:

How many children are you registering? *
Child 1
Full name: *

First Name Last Name
Hebrew name:
Full Hebrew name: ben/bat followed by father's full Hebrew name (ben is 'son of' and bat is 'daughter of').
Date of birth: *

Month Day Year Date Picker Icon
Bar/Bat Mitzvah date :

Month Day Year Date Picker Icon
Gender: *
School grade: *
School attending: *
Email (if applicable):
example@example.com
Cell phone (if applicable):

Area Code Phone Number
Child 2
Full name: *

First Name Last Name
Hebrew name:
Full Hebrew name: ben/bat followed by father's full Hebrew name (ben is 'son of' and bat is 'daughter of').
Date of birth: *

Month Day Year Date Picker Icon
Bar/Bat Mitzvah date :

Month Day Year Date Picker Icon
Gender: *
School grade: *
School attending: *
Email (if applicable):
example@example.com
Cell phone (if applicable):

Area Code Phone Number
Child 3
Full name: *

First Name Last Name
Hebrew name:
Full Hebrew name: ben/bat followed by father's full Hebrew name (ben is 'son of' and bat is 'daughter of').
Date of birth: *

Month Day Year Date Picker Icon
Bar/Bat Mitzvah date :

Month Day Year Date Picker Icon
Gender: *
School grade: *
School attending: *
Email (if applicable):
example@example.com
Cell phone (if applicable):

Area Code Phone Number
Child 4
Full name: *

First Name Last Name
Hebrew name:
Full Hebrew name: ben/bat followed by father's full Hebrew name (ben is 'son of' and bat is 'daughter of').
Date of birth: *

Month Day Year Date Picker Icon
Bar/Bat Mitzvah date :

Month Day Year Date Picker Icon
Gender: *
School grade: *
School attending: *
Email (if applicable):
example@example.com
Cell phone (if applicable):

Area Code Phone Number
Child 5
Full name: *

First Name Last Name
Hebrew name:
Full Hebrew name: ben/bat followed by father's full Hebrew name (ben is 'son of' and bat is 'daughter of').
Date of birth: *

Month Day Year Date Picker Icon
Bar/Bat Mitzvah date :

Month Day Year Date Picker Icon
Gender: *
School grade: *
School attending: *
Email (if applicable):
example@example.com
Cell phone (if applicable):

Area Code Phone Number

Do you have any yahrzeits you wish to observe and for which to receive notifications? *
Yahrzeit Notifications
Jewish custom calls for observing the anniversary of the death of parents, children, spouses, and siblings according to the Jewish calendar. Please complete the information below, so that we may remind you of yarhrzeit dates. The full date of death is required in order to schedule yahrzeits.
Full name (English): *

First Name Last Name
Hebrew name:
Relationship to adult #1 or #2: *
Date of death (secular): *

Month Day Year
Date Picker Icon
Date of death (Hebrew): *
Time of death: *

: Hour Minutes AM/PM Option

Membership Levels
Single Membership
- Ages 18-29 - $410
- Ages 30-35 - $788
- Ages 36 and Up - $1,445
Family Membership
- Ages 18-29 - $793
- Ages 30-35 - $1,470
- Ages 36 and Up - $2,510
Associate Membership
- All Levels - $620
Choose membership type: *

Single Membership - $410 Single Membership - $788 Single Membership - $1,445 Family Membership - $793 Family Membership - $1,470 Family Membership - $2,510 Associate Membership - $620
Security fee: *

$175
Total:
Includes Convenience Fee (3% of Total)
I (we) hereby apply for membership at Ahavath Achim Congregation and when accepted I (we) promise to abide by the rules and regulations of the Synagogue. I (we) agree to pay the first year’s dues in the total amount listed above and thereafter, such annual dues as may be fixed by the Synagogue Board of Trustees, in accordance with the by-laws of the Congregation. I (we) understand that the fiscal year for payment of all Ahavath Achim accounts is July 1 - June 30. I (we) have received and understand all commitments regarding Security Fee policy and payment schedules. I (we) understand that our account must be current in order to have a life cycle event or receive High Holiday tickets at Ahavath Achim. This application is accompanied by the total amount listed above as payment for our first year commitment to Ahavath Achim Congregation.To The Board Of Trustees: I/We hereby apply for membership in Ahavath Achim Synagogue, and if accepted, agree to abide by all rules and regulations at present in effect, or hereafter promulgated for the conduct and operation of the congregation. *

I (we) agree

Payment: *

USD Description

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Should be Empty:

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Membership Application

Adult 1

Adult 2

Child 1

Child 2

Child 3

Child 4

Child 5

Yahrzeit Notifications

Additional Questions

Membership Levels