Become a Member

If you need help filling out the form, please contact the office at (973) 584-5666 or administrator@tshalom.org. Thank you!

Account Information

Preferred Pronouns

Title

* First Name-Adult 1

* Last Name-Adult 1

* DOB-Adult 1

Preferred phone

HomeMobile

* Mobile Phone-Adult 1

Home Phone-Adult 1

* Email-Adult 1

May we list your information in our online Member Directory?

YesNo

* Address 1

Address 2

* City

* State

* Zip

Occupation/Profession & Position/Title

Company Name

Specializations/Areas of expertise (work or other)

* Marital Status

Married/PartnersDivorced/SeparatedSingleWidowed

Anniversary Date (MM/DD/YY)

Hebrew Name

Phonetically-- example Malka ben/bat Yakov/Yohevet

* 1. Would you like to add another adult to your account?

NOTE: Either as the second member on your account; or just as another contact for Temple Shalom.

Preferred pronouns

Title

* First Name-Adult 2

* Last Name-Adult 2

DOB-Adult 2

* Preferred phone

HomeMobile

* Mobile Phone-Adult 2

Home Phone-Adult 2

* Email-Adult 2

* Occupation/Profession & Position/Title

Company Name

Specializations/Areas of expertise (work or other)

Hebrew Name

Phonetically-- example Malka ben/bat Yakov/Yohevet

* 2. Are there any children you would like associated with your account?

18 years or younger

3. Please select the # of children

Preferred Pronouns

First Name-Child 1

Last Name-Child 1

DOB-Child 1 (MM/DD/YY

Grade for 2023/2024 school year

District/Name of School

Hebrew Name-Child 1

Phonetic

Bar/Bat Mitzvah date-Child 1

if past, or if known for future

Confirmation Date-Child 1

if past

Preferred pronouns

* First Name-Child 2

* Last Name-Child 2

DOB-Child 2

Grade for 2023/2024school year

District/Name of School

Hebrew Name-Child 2

Phonetic

Bar/Bat Mitzvah date-Child 2

if past, or known for future

Confirmation Date-Child 2

Preferred pronouns

* First Name-Child 3

* Last Name-Child 3

DOB-Child 3

Grade for 2023/2024 school year

District/Name of School

Hebrew Name-Child 3

phonetic

Bar/Bat Mitzvah date-Child 3

if past, or known for future

Confirmation Date- Child 3

Preferred pronouns

* First Name-Child 4

* Last Name-Child 4

Birth Date-Child 4 (MM/DD/YYYY)

Grade for 2023/2024 school year

District/Name of School

Hebrew Name-Child 4

phonetic

Bar/Bat Mitzvah date-Child 4

if past, or known for future

Confirmation Date- Child 4

Member Acknowledgement

* By checking this box, I hereby acknowledge that:

By checking this box, I hereby acknowledge that:

All information provided is accurate to the best of my knowledge.
In the future, Temple Shalom Membership shall automatically renew at the start of the fiscal year, July 1st.
I am responsible for all financial obligations that I incur with Temple Shalom.
Special Arrangements do not renew automatically and must be requested each year (with supporting documentation), before the start of the fiscal year, July 1st. In the absence of a request and all supporting documentation from me, Temple Shalom will assume my financial hardship has been resolved and I will be renewing my full membership contribution to the community.
Temple Shalom Membership renewal will be done at the same membership category, same prevailing dues level, and with the same payment method at the time of renewal, unless I inform Temple Shalom in writing before the start of the fiscal year, July 1st.
It is my responsibility to contact Temple Shalom if there are any changes to my payment method, membership status, and/or information concerning members of my household.

Religious School Registration

To register your children for Religious School please click here.

Temple Shalom New Member Application 2023-2024

Become a Member

Account Information

Member Acknowledgement

Religious School Registration

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