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Membership Application
Please verify reCaptcha before submitting the form.
How many adult Members are part of this membership?
Please Select One
One Adult
Two Adults
Member 1 - First Name
Member 1 - Middle Name
Member 1 - Last Name
Member 1 - Date of Birth
Member 1 - Hebrew Name
Member 1 - Home Address
Member 1 - Home City
Member 1 - Home State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Member 1 - Home ZIP
Member 1 - Mobile Phone
Member 1 - Email
Member 1 - Gender
N/A or Unknown
Male
Female
Member 1 - Occupation
Member 1 - Employer
Member 1 - Work Phone
Our volunteers are the life & breath of our congregation & the reason our congregation thrives. Participation in the Synagogue activities enriches the synagogue membership experience for everyone. Even a small amount of time on a single project is welcome and greatly appreciated. Please indicate below the area(s) in which you would like to volunteer
Choir and Music Committee
College Outreach Committee
Education Advisory Committee
Fundraising Committee
Gan Shalom Nursery School Committee
House Committee
Israel Engagement Committee
Marketing and Communications Committee
Membership Advisory Committee
Mutual Support Advisory Committee
Ritual Advisory Committee
Social Action Committee
Interest or skills?
Do you play a musical instrument? if so, what instrument?
Member 2 - First Name
Member 2 - Middle Name
Member 2 - Last Name
Member 2 - Date of Birth
Member 2 - Hebtrew Name
Member 2 - Mobile Phone
Member 2 - Email
Member 2 - Gender
N/A or Unknown
Male
Female
Member 2 - Occupation
Member 2 - Employer
Member 2 - Work Phone
Our volunteers are the life & breath of our congregation & the reason our congregation thrives. Participation in the Synagogue activities enriches the synagogue membership experience for everyone. Even a small amount of time on a single project is welcome and greatly appreciated. Please indicate below the area(s) in which you would like to volunteer
Choir and Music Committee
College Outreach Committee
Education Advisory Committee
Fundraising Committee
Gan Shalom Nursery School Committee
House Committee
Israel Engagement Committee
Marketing and Communications Committee
Membership Advisory Committee
Mutual Support Advisory Committee
Ritual Advisory Committee
Social Action Committee
Interest or skills?
Do you play a musical instrument? if so, what instrument?
Does Member 2 live at the same address?
Please Select One
Yes
No
Member 2 - Home Address
Member 2 - Home City
Member 2 - Home State
Member 2 - Home ZIP
Member 2 - Home Phone
How many children live in your home?
Please Select One
None
One child
Two children
Three children
Four children
Five children
Six children
First Name
Last Name
Gender
N/A or Unknown
Male
Female
Date of Birth
School Grade
Name of School
Will attend:
Gan Shalom Nursery School
Synagogue School
Teen Programming
First Name
Last Name
Gender
N/A or Unknown
Male
Female
Date of Birth
School Grade
Name of School
Will attend:
Gan Shalom Nursery School
Synagogue School
Teen Programming
First Name
Last Name
Gender
N/A or Unknown
Male
Female
Date of Birth
School Grade
School Name
First Name
Last Name
Gender
N/A or Unknown
Male
Female
Date of Birth
School Grade
School Name
Will attend:
Gan Shalom Nursery School
Synagogue School
Teen Programming
First Name
Last Name
Gender
N/A or Unknown
Male
Female
Date of Birth
School Grade
School Name
Will attend:
Gan Shalom Nursery School
Synagogue School
Teen Programming
First Name
Last Name
Gender
N/A or Unknown
Male
Female
Date of Birth
School Grade
School Name
Will attend:
Gan Shalom Nursery School
Synagogue School
Teen Programming
Are there other adults living in the same household?
Please Select One
Yes
No
Please list any adult children or grandchildren that are members of your household.
If you want a notice sent to you as a reminder of an upcoming yahrzeit, please click the + button to add each yahrzeit.
Name of Deceased
Relationship
English Date of Death
Send letter on:
Please Select One
English Date
Hebrew Date
How or from what source did you learn about the Reconstructionist Synagogue of North Shore
Are there any comments you would like to include?
*
Please select your annual membership support level
Please Select One
Individual Membership
Household Membership
I am requesting financial aid
Every person is valued at RSNS and we would never turn anyone away due to a financial hardship. If you need financial assistance, please choose 'I am requesting financial aid' in the dropdown menu above and contact Liza Wilson at ExecutiveDirector@rsns.org
*
To further the work of RSNS and for capital improvement, members agree to pay a one-time fee of $1815 to RSNS (for its Building Fund) payable:
Please Select One
In full with this application
Annually at $302.50 p/year - first years payment with this application
I am requesting financial aid
Total:
Thu, May 1 2025 3 Iyyar 5785
