Membership Registration Form

Welcome to our Synagogue

Congregation Beth Shalom of the Blue Hills is a thriving, independent, diverse, egalitarian Jewish community serving the towns of the South Shore and adjacent Boston neighborhoods. We have experienced a surge in membership since we have moved into our new building. In the midst of this growth we remain a close-knit, friendly community, where we enjoy celebrating simchas together, and provide support to each other during difficult times.

Our members come from a wide geographic area including Canton, Stoughton, Sharon, Milton, Quincy, Randolph, Weymouth, Hingham, Braintree, Dorchester, Mattapan and Hyde Park. Members of our congregation come from a diverse array of backgrounds. We welcome all who are interested in joining our synagogue community: singles and couples of all ages, young and ‘not so young’ families, members of the LGBTQIA community, peoples of all abilities, Interfaith couples and people of all races.

We welcome your interest in our synagogue, and in joining our community. Please feel free to visit us for Erev Shabbat/Friday night or Shabbat/Saturday morning services, or for any of our other activities.

If you would like information about our upcoming services or events, or have specific questions not answered on our website, please contact the Temple office:

Email: office@bethshalombluehills.org
Or call the Temple Office: 617-698-3394

If you are interested in joining our synagogue community please fill out the form below. We welcome people of all backgrounds and levels of exposure to Judaism. Please fill out the form to the best of your ability and feel free to call the office for assistance of any kind.

Date

Last name, to be used in the directory

Home Phone Number

Address

City

State

Zip Code

Adult 1 - Title

* Adult 1 - First Name

* Adult 1 - Last Name

Adult 1 - Preferred Name

* Adult 1 - Gender

Adult 1 - Mobile Phone

Adult 1 - Email

Adult 1 - Occupation

Adult 1 - Employer

Adult 1 - Hebrew Name

Hebrew or English phonetically

Adult 1 - Mother's Hebrew Name

Hebrew or English phonetically

Adult 1 - Father's Hebrew Name

Hebrew or English phonetically

* Tribe

CBSBH welcomes people with diverse Jewish backgrounds. Please fill this out to the best of your ability.

Adult 1 - Previous Synagogue Experience/Involvement

Adult 1 - Previous Jewish Cultural Experience/Involvement

(Camp, Israel Trip, Youth Group, etc.)

Adult 1 - Bar/Bat Mitzvah Date

if applicable

Adult 1 - Hobbies/Talents and Interests:

Adult 1 - Tzedakot/Charities or Social Justice Programs you care about:

We encourage all members of the synagogue community to join a team as soon as they are comfortable doing so. Please check any of the following teams that you may want to contribute to.

Please let us know if is there anything we can do to make your participation at any event that the synagogue community offers more accessible or comfortable. Ex: help with transportation, hearing loops, entrance or seating support.

Please let us know if you have any food allergies or issues that we can accommodate when we serve food.

* Is there a second adult applying for Membership?

Adult 2 - Title

* Adult 2 - First Name

* Adult 2 - Last Name

Adult 2 - Preferred Name

* Adult 2 - Gender

Adult 2 - Mobile Phone

Adult 2 - Email

Adult 2 - Occupation

Adult 2 - Employer

Adult 2 - Hebrew Name

Hebrew or English phonetically

Adult 2 - Mother's Hebrew Name

Hebrew or English phonetically

Adult 2 - Father's Hebrew Name

Hebrew or English phonetically

* Tribe

CBSBH welcomes people with diverse Jewish backgrounds. Please fill this out to the best of your ability.

Adult 2 - Previous Synagogue Experience/Involvement

Adult 2 - Previous Jewish Cultural Experience/Involvement

(Camp, Israel Trip, Youth Group, etc.)

Adult 2 - Bar/Bat Mitzvah Date

if applicable

Adult 2 - Hobbies/Talents and Interests:

Adult 2 - Tzedakot/Charities or Social Justice Programs you care about:

We encourage all members of the synagogue community to join a team as soon as they are comfortable doing so. Please check any of the following teams that you may want to contribute to.

Social ActionSocial Media, Branding & CommunicationsSpiritual Life and Ritual

Please let us know if you have any food allergies or issues that we can accommodate when we serve food.

Is there a third Adult living in the family home?

Adult 3 - Title

* Adult 3 - First Name

* Adult 3 - Last Name

Adult 3 - Preferred Name

* Adult 3 - Gender

Adult 3 - Mobile Phone

Adult 3 - Email

Adult 3 - Occupation

Adult 3 - Employer

Adult 3 - Hebrew Name

Hebrew or English phonetically

Adult 3 - Mother's Hebrew Name

Hebrew or English phonetically

Adult 3 - Father's Hebrew Name

Hebrew or English phonetically

* Tribe

CBSBH welcomes people with diverse Jewish backgrounds. Please fill this out to the best of your ability.

Adult 3 - Previous Synagogue Experience/Involvement

Adult 3 - Previous Jewish Cultural Experience/Involvement

(Camp, Israel Trip, Youth Group, etc.)

Adult 3 - Bar/Bat Mitzvah Date

if applicable

Adult 3 - Hobbies/Talents and Interests:

Adult 3 - Tzedakot/Charities or Social Justice Programs you care about:

Please let us know if you have any food allergies or issues that we can accommodate when we serve food.

Is there a fourth Adult living in the family home?

Adult 4 - Title

* Adult 4 - First Name

* Adult 4 - Last Name

Adult 4 - Preferred Name

* Adult 4 - Gender

Adult 4 - Mobile Phone

Adult 4 - Email

Adult 4 - Occupation

Adult 4 - Employer

Adult 4 - Hebrew Name

Hebrew or English phonetically

Adult 4 - Mother's Hebrew Name

Hebrew or English phonetically

Adult 4 - Father's Hebrew Name

Hebrew or English phonetically

* Tribe

CBSBH welcomes people with diverse Jewish backgrounds. Please fill this out to the best of your ability.

Adult 4 - Previous Synagogue Experience/Involvement

Adult 4 - Previous Jewish Cultural Experience/Involvement

(Camp, Israel Trip, Youth Group, etc.)

Adult 4 - Bar/Bat Mitzvah Date

if applicable

Adult 4 - Hobbies/Talents and Interests:

Adult 4 - Tzedakot/Charities or Social Justice Programs you care about:

Please let us know if you have any food allergies or issues that we can accommodate when we serve food.

* How many children 18 year or younger live in the family home?

Child 1 - First Name

Child 1 - Last Name

Child 1 - Hebrew Name

spell phonetically using English letters

Child 1 - Gender

spell phonetically using English letters

Child 1 - Birthdate

Child 1 - Bar/Bat Mitzvah Date

if applicable

Child 1 - Grade in Secular School

Child 1 - School Name

Please let us know if Is there anything we can do to make your participation at any event that the shul community offers more accessible or comfortable. Ex: help with transportation, hearing loops, entrance or seating support.

Please let us know if your child has any food allergies or issues that we can accommodate when we serve food.

Child 2 - First Name

Child 2 - Last Name

Child 2 - Hebrew Name

spell phonetically using English letters

Child 2 - Gender

spell phonetically using English letters

Child 2 - Birthdate

Child 2 - Bar/Bat Mitzvah Date

if applicable

Child 2 - Grade in Secular School

Child 2 - School Name

Please let us know if your child has any food allergies or issues that we can accommodate when we serve food.

Child 3 - First Name

Child 3 - Last Name

Child 3 - Hebrew Name

spell phonetically using English letters

Child 3 - Gender

spell phonetically using English letters

Child 3 - Birthdate

Child 3 - Bar/Bat Mitzvah Date

if applicable

Child 3 - Grade in Secular School

Child 3 - School Name

Please let us know if your child has any food allergies or issues that we can accommodate when we serve food.

Child 4 - First Name

Child 4 - Last Name

Child 4 - Hebrew Name

spell phonetically using English letters

Child 4 - Gender

spell phonetically using English letters

Child 4 - Birthdate

Child 4 - Bar/Bat Mitzvah Date

if applicable

Child 4 - Grade in Secular School

Child 4 - School Name

Please let us know if your child has any food allergies or issues that we can accommodate when we serve food.

Child 5 - First Name

Child 5 - Last Name

Child 5 - Hebrew Name

spell phonetically using English letters

Child 5 - Gender

spell phonetically using English letters

Child 5 - Birthdate

Child 5 - Bar/Bat Mitzvah Date

if applicable

Child 5 - Grade in Secular School

Child 5 - School Name

Please let us know if your child has any food allergies or issues that we can accommodate when we serve food.

Child 6 - First Name

Child 6 - Last Name

Child 6 - Hebrew Name

spell phonetically using English letters

Child 6 - Gender

spell phonetically using English letters

Child 6 - Birthdate

Child 6 - Bar/Bat Mitzvah Date

if applicable

Child 6 - Grade in Secular School

Child 6 - School Name

Please let us know if your child has any food allergies or issues that we can accommodate when we serve food.

A yahrzeit is the anniversary of the death of a parent, sibling, spouse or child. Member should feel free to include include non-Jewish relatives if they wish.

* How many Yahrzeits would you like to observe?

English Name

Date of Death

Related to?

Relationship

English Name

Date of Death

Related to?

Relationship

English Name

Date of Death

Related to?

Relationship

English Name

Date of Death

Related to?

Relationship

English Name

Date of Death

Related to?

Relationship

English Name

Date of Death

Related to?

Relationship

* Please select a Membership Commitment level:

We appreciate that there are times that special dues consideration may be necessary. We are 100% committed to ensuring everyone can affiliate with our Temple community, regardless of their financial situation. If you have questions about meeting the financial obligations of membership, our President Paul Cooperstein (paul@businessmomentum.org) or Steve Ostrovitz (sostrovitz@ostrovitzlaw.com) are available to have a confidential meeting or phone call to discuss a plan that works for you.

Household Plus: How many Adult relatives live in the same household that you would like to extend membership to?

This category applies to two adults who live in the same household and would like to extend membership to adult relative(s) who live in the same or separate household(s).
If the two adults live in separate homes, please include additional name and address:

Young Adult: up to 26 years old, includes one High Holiday ticket.

Graduates of our religious school, who are undergraduate or graduate college students, are granted affiliation for free

One Adult Household: includes one High Holiday ticket.

Two Adult Household/s: includes two High Holiday tickets.

This category applies to two adults in one or separate household(s).
If the two adults live in separate homes, please include additional name and address:

Associate Membership: Includes 1 High Holiday ticket for additional $100.

For those who have primary membership with another synagogue but also want to maintain their affiliation with our congregation.

Additional Contribution - Members of the congregation who are willing to do so may contribute beyond their required membership dues to help support a discounted membership for those with lesser financial means.

Please enter an amount above if you wish to give.

* Thanks to the Adas Shalom Fund, we offer an automatic per-student scholarship of $290 for the forthcoming year. Are you enrolling children in our religious school?

Please select the amount of children being enrolled in our Religious School:

K-2nd Grade (one day per week) - $740 per year

3rd-7th Grade (two days per week) - $890 per year

Please select the amount of children being enrolled in our Religious School:

K-2nd Grade (one day per week) - $450 per year

3rd-7th Grade (two days per week) - $600 per year

Total Commitment

Includes Membership and Religious School (if selected). Please click the submit button below. Once clicked you will be taken to a payment page where you can arrange payment and will have the opportunity to split your payments if desired.

Todah Rabbah/Thank you very much for your ongoing commitment to Congregation Beth Shalom of the Blue Hills.

Fri, May 3 2024 25 Nisan 5784