Beis Gavriel Membership Form
Beis Gavriel is delighted to have you as a member, please fill in the following form, one form per household, with as much detail as you can to allow our community to serve you in the best way possible. Please note the information contained in these forms will be kept strictly confidential and will only be used by Beis Gavriel shul and the Federation of synagogues for its administrative and operational purposes.
This information will be held on the Beis Gavriel / Federation central database and is accessible to certain employees and volunteers eg board members all of whom have had GDPR training. Access is only granted where there is a valid operational purpose, your information will never be shared with a third party without your explicit consent.
Primary email address for correspondence
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example@example.com
Do you consent to Beis Gavriel Shul and the Federation Head Office holding the data you enter into this form and using it to administrate your membership and provide you with appropriate services ? You have the right to view the data we hold and to withdraw your consent at any time .
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Yes
No
Do you consent to us contacting you about Beis Gavriel events and services using the contact information you have provided ?
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Yes
No
Other
What is your household Surname?
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Please type the full name, including title, of the person you would like listed as the PRIMARY household contact ?
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Please enter the Date of Birth of the Primary household contact.
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Month
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Day
Year
Date Picker Icon
Hebrew Date of Birth of the Primary contact
Marital Status
Married
Single
Separated
Other
Name of secondary household contact/spouse (if applicable)
Please enter the date of birth of secondary household contact / spouse
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Month
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Day
Year
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Hebrew Date of Birth of secondary contact
email address of secondary contact
Please add your full UK mailing address and postcode.
*
Please provide a primary telephone number for Beis Gavriel to contact you.
*
Please provide secondary contact/spouse telephone number:
Your Beis Gavriel membership for 2026 will cost £37.50 per month, per adult member in the household over the age of 21. If you opt in to the Burial scheme there will be an additional cost which will vary depending on your age (see form below). How would you like to pay your Beis Gavriel membership ?
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Direct Debit
Charity cheques
Online Charity account payment
BACS - Online bank transfer
Other
Do you have existing Burial cover?
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Yes
No
If YES please let us know which Burial Scheme you are a part of .
Would you like to be a part of the Beis Gavriel Federation Burial Scheme ?
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Yes, please bill me for membership and burial
No , I do not want to be a part of the Federation Burial scheme, please bill me for membership only
Other
If you would like to join the Federation Burial Society, please fill out and submit the completed form below:
Upload Burial Society application form.
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Burial applications must be accompanied by documentary evidence of Halachic Jewish status e.g. a Kesubah. Upload here:
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If you are married please enter the date of your marriage .
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Month
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Day
Year
Date Picker Icon
If you were married in a Jewish Ceremony please let us know who officiated at your wedding/ under whose auspices you were married.
If you are married and know the Hebrew date of your marriage please enter it here.
Please select from the following:
Cohen
Levi
Yisrael
Please list Yahrzeit dates you would like us to be aware of along with full Hebrew & English names and relationship to you:
Has the primary contact been divorced?
Yes
No
Has the secondary contact been divorced?
Yes
No
Hebrew name of primary contact (including name of both parents)
Hebrew name of secondary contact (including name of both parents)
Do you have children ?
*
Yes
No
If you have children, please list the following details for each child: English & Hebrew name, date of birth (English and Hebrew), name of school/nursery and any contact information you would like us to hold for them
Comments:
Gift Aid Declaration
Registered Charity Number 254951
I confirm that I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year, it is my responsibility to pay any difference.I would like the charity to treat all donations I have made from 6 April 2022and all future donations, as Gift Aid donations, unless I notify you otherwise.
Yes
Signature
Date
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Month
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Day
Year
Date
Notes:
You must pay an amount of income tax and / or capital gains tax at least equal to the tax that the charity reclaims on your donations in the tax year at the basic rate.
If in the future, your circumstances change and you no longer pay tax on your income and capital gains equal to the tax that the charity reclaims, you can cancel your declaration (see note 4)
If you pay tax at the highest rate, you can claim further tax relief in your Self Assessment tax return.
You can cancel the declaration at any time by notifying the charity.
If you are unsure whether your donations qualify for Gift Aid tax relief, as the charity or you can ask your local tax office for appropriate information.
Please notify the charity when you change your name or address.
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