This is an example of a form you can replicate when you are speaking to a prospective synagogue member. This is a FREE Google Form and it has the ability to email anyone who might want to contact the prospective member such as your rabbi, president, membership chair, executive director, etc.

This is going to be more in-depth than a "Contact Us" form. The idea is to help you organize your notes about this person, not for them to fill it out and send it back to you.