Become a Member

Membership Form

Please fill out the form below with whatever fields are applicable. Thank you for joining our family!

Family Name

Your First Name

Your Spouse's First Name

Wife's Maiden Name

Please enter your full Hebrew name (ex: Shlomo ben Yaakov Meir or Sarah bas Chana)

Your Email Address

Your Spouse's Email Address

Your Street Address

Your City, State and ZIP code

Your Home Phone

Your Cell Phone

Your Spouse's Cell Phone

Please enter the names and ages of your children

Has any member of your family been converted?

What is your preferred method of communication?

Would you be interested in hosting Shabbos guests for a meal?

Would you be interested in hosting Shabbos guests to sleep over?

Please list important dates like birthdays, yahrzeits, etc (one per line)

Would you like to be listed in our Shul Directory?

Annual Membership Dues

Family dues .... $1,500
Individual dues .... $1,000
Associate Member .... $500

I/We would like to join as

How would you like to pay your dues?

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6721 51ST AVE S | SEATTLE | WA 98118
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