GRS Membership Form

* Title

* First Name

* Last Name

* Hebrew Name

Email Address

* Phone Number

Spouse's Title

Spouse's First Name

Spouse's Last Name

Spouse's Hebrew Name

Spouse's Email Address

Spouse's Phone Number

* Home Address

Children's Names and Birthdays

* Were all the members of your family born Jewish?

YesNo

If not, please explain:

* Would any family member like to participate in services (Chazan/ Layning)?

YesNo

* Would any family member like to participate in committees?

Previous Synagogue Affiliation:

Other Synagogue Affiliations:

Thank you for filling out the Green Road Synagogue member ship application. The office will contact you shortly to discuss membership dues.

Tue, December 18 2018 10 Tevet 5779