Membership Application

If you have any questions, please contact Elizabeth Hart, Membership Engagement and Development Associate, at ehart@chizukamuno.org or call 410-486-6400.

* Title

* First Name

Informal Name

* Last Name

Pronouns

Why is this important?

* Gender

* Mobile Phone

* Email

* Date of Birth

* Do you wish to receive our weekly e-mail newsletter?

* Tribe

* Hebrew Name

* Parent 1 Hebrew Name

* Parent 2 Hebrew Name

* Bar/Bat/B Mitzvah Date

* Occupation

* Work Title

* Brief Description

* Work Phone

* Are you interested in volunteering or serving on a committee?

Would you like to add a second adult to your membership form?

* Title

* First Name

Informal Name

* Last Name

Pronouns

Why is this important?

* Gender

* Mobile Phone

* Email

* Date of Birth

* Do you wish to receive our weekly e-mail newsletter?

* Tribe

* Hebrew Name

* Parent 1 Hebrew Name

* Parent 2 Hebrew Name

* Bar/Bat/B Mitzvah Date

* Occupation

* Work Title

* Brief Description

* Work Phone

* Are you interested in volunteering or serving on a committee?

Address

City

State

Zip Code

Home Phone

if applicable

Wedding Anniversary (mm/dd/yr)

if applicable

Do you have a winter or summer home address?

If yes, please notify the synagogue office of effective leave and return dates each season.

Winter/Summer - Address

Winter/Summer - City

Winter/Summer - State

Winter/Summer - Zip Code

This section is for Children that are currently living at home/in school.

* Please select how many children you would like to include?

* First Name

* Last Name

Informal/Preferred Name

Hebrew Name

* Date of Birth

* Gender

Pronouns

Why is this important?

* Email

* Mobile Phone

Bar/Bat/B Mitzvah Date (Actual or Expected)

* Current Grade

* School

Name of School

Projected Year of Graduation

* First Name

* Last Name

Informal/Preferred Name

Hebrew Name

* Date of Birth

* Gender

Pronouns

Why is this important?

* Email

* Mobile Phone

Bar/Bat/B Mitzvah Date (Actual or Expected)

* Current Grade

* School

Name of School

Projected Year of Graduation

* First Name

* Last Name

Preferred Name

Hebrew Name

* Date of Birth

* Gender

Pronouns

Why is this important?

* Email

* Mobile Phone

Bar/Bat/B Mitzvah Date (Actual or Expected)

* Current Grade

* School

Name of School

Projected Year of Graduation

* First Name

* Last Name

Preferred Name

Hebrew Name

* Date of Birth

* Gender

Pronouns

Why is this important?

* Email

* Mobile Phone

Bar/Bat/B Mitzvah Date (Actual or Expected)

* Current Grade

* School

Name of School

Projected Year of Graduation

If you would like to provide information about your adult children, please complete this section.

How many children do not live at home?

First Name

Last Name

Date of Birth

Spouse's Name

First Name

Last Name

Date of Birth

Spouse's Name

First Name

Last Name

Date of Birth

Spouse's Name

If you would like to receive yahrzeit notifications, please list all yahrzeit records available. Complete information is necessary in order to be able to notify you. If you do not know the exact time of death, PLEASE INDICATE IF IT WAS BEFORE OR AFTER SUNSET.

How many yahrzeits would you like to record?

Name in Hebrew

Name in English

Relationship

Relationship to

Date of Death

Before/After Sunset?

Name in Hebrew

Name in English

Relationship

Relationship to

Date of Death

Before/After Sunset?

Name in Hebrew

Name in English

Relationship

Relationship to

Date of Death

Before/After Sunset?

Name in Hebrew

Name in English

Relationship

Relationship to

Date of Death

Before/After Sunset?

* Do you have relatives/family that are also members of Chizuk Amuno Congregation?

If yes, please list family name and relationship:

Dues Schedule 2024-2025. Our structure is split by age range and then into Single-Adult Household (Aleph) and Two Adult Household (Bet), from there it is broken into age range. View the membership structure here.

We offer friends of Chizuk Amuno Congregation, who are members of another synagogue, the opportunity to join at the Associate Membership level. Associate Membership does not include High Holy Day seats, school tuition discounts, access to Garrison Forest Cemetery sites, and does not require payment of the Building Fund.

Personal financial hardship is never a barrier to synagogue membership. Membership Dues variances and school scholarships are available for those with financial need. Please get in touch with David Schimmel (410-486-6400) for a confidential discussion.

Are you interested in "Aleph" Single-Adult or "Bet" Two-Adult Household Membership

Aleph -1 AdultBet - 2 Adult

Please rank according to your preference. ex 1, 2 or 3, if you are joining as an Associate Member please choose "Not Applicable"

Sanctuary Floor

Sanctuary Balcony

Krieger Auditorium

Building Fund
Our Building Fund is a one-time fee of $2,000 for a Bet household and $1,000 for an Aleph household, not required until one adult in the household reaches the age of 30. The Building Fund is payable over a five-year period.

Associate Membership
We offer friends of Chizuk Amuno who are members of another synagogue the opportunity to join at the Associate Membership level. Associate Membership does not include High Holy Day seats, school tuition discounts, camp scholarships, security fee waivers, access to Garrison Forest Cemetery sites, and does not require payment of the Building Fund.

Voluntary Contributions in support of the Conservative Movement

	ALEPH	BET
United Synagogue of Conservative Judaism	$36.50	$72.50
Jewish Theological Seminary of America	$10	$20
Mercaz USA / Israel Support	$36	$54

THANK YOU for taking the time to complete this form. Elizabeth Hart, our Membership Engagement & Development Associate, will contact you within 48 hours of your submission.

Thu, June 12 2025 16 Sivan 5785