AA Membership Application

Membership Application

Welcome to Ahavath Achim Synagogue!
Ahavath Achim cultivates a Jewish community of purposeful belonging. We inspire and support spiritual journeys by deepening relationships with one another. We believe it is at the crossroads of our spiritual paths that life's purpose and God might be found. Ahavath Achim creates a vibrant, inclusive, spiritual community that empowers individuals to connect Jewishly beyond themselves. AA embraces interfaith families who desire to be part of our Jewish community. Our spiritual community serves all who wish to connect with us.

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 the Director of Outreach and Engagement: Miriam Habif (mhabif@aasynagogue.org; 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: *

Area Code Phone Number
Home phone:

Area Code Phone Number
Work phone:

Area Code Phone Number
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Date of birth: *

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

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

MM DD YYYY
Date
Bar/Bat Mitzvah date:

MM DD YYYY
Date
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: *

Area Code Phone Number
Home phone:

Area Code Phone Number
Work phone:

Area Code Phone Number
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Date of birth: *

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

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

MM DD YYYY
Date
Bar/Bat Mitzvah date:

MM DD YYYY
Date
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: *

MM DD YYYY
Date
Bar/Bat Mitzvah date :

MM DD YYYY
Date
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: *

MM DD YYYY
Date
Bar/Bat Mitzvah date :

MM DD YYYY
Date
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: *

MM DD YYYY
Date
Bar/Bat Mitzvah date :

MM DD YYYY
Date
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: *

MM DD YYYY
Date
Bar/Bat Mitzvah date:

MM DD YYYY
Date
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
Bar/Bat Mitzvah date :

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

: Hour Minutes AM/PM Option

Membership and Payment
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: *

$225
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
Total:

Total: *

USD Includes Convenience Fee (3% of Total)

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 and Payment