Shoreshim Membership Registration July 1 2016 - June 30 2017
NOTE: Your answers to this form will not be saved until you hit SUBMIT at the bottom of the last page.

Shoreshim is a participatory congregation with each adult member serving on two committees. Teenagers and young adults are encouraged to join a committee, but are not required to do so.

Shoreshim is proud to offer a senior membership to those who are 60 years or older. While senior members have no obligation to serve, we strongly encourage senior members to join holiday or Shabbat committees.
Primary Member
First Name *
Your answer
Last Name *
Your answer
Gender
Primary Phone *
Your answer
Home Phone
Your answer
Work Phone
Your answer
Cell Phone
Your answer
Email 1 *
Your answer
Email 2
Your answer
Address Line 1 *
Your answer
Address Line 2
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Is this person a senior? (60+) *
Next
Never submit passwords through Google Forms.
This form was created inside of Shoreshim. Report Abuse