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Petaluma's Inclusive Center for Jewish Life
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New Membership Application
Please verify reCaptcha before submitting the form.
Welcome to B'nai Israel Jewish Center. Our mission is to provide an inclusive center for Jewish life that addresses the cultural, religious, spiritual, educational and social needs of those who wish to identify with the Jewish community in Petaluma and surrounding areas. We have proudly served the local community since 1864.
Please fill out the form below. Once your application has been approved by the Board, you will be notified.
Please check membership type
Individual $1,000
Family $1,820
Associate $500 (you are a member of another congregation)
Friend of B'nai Israel $500 (non-Jewish member)
Full-time Local Student - Suggested Donation of $180
Gan Israel Family (Entitled to discounted membership of $180 while children attend Gan Israel
I’d like to speak with the treasurer about reduced dues
Member(s) Information
*
First Name
*
Last Name
Please select preferred pronouns (optional)
He/Him/His
She/Her/Hers
They/Them/Their
Other
*
Email Address
This will be the email address you use to log in to your Shulcloud account, our software database, and receive statements, announcements and the bulletin. Please choose an address you check regularly. You will receive instructions on how to login to your Shulcloud account after your membership has been approved.
Cell Phone
*
Primary Phone
I prefer to be reached by...
Email
Phone Call
Text Message
Your birthdate - Month/Day/Year
Wedding anniversary or Commitment date, if known.
*
Home Address
Please include apartment or unit numbers. Ex: 221 Baker St. Unit B
*
City
*
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
*
ZIP Code
Volunteer and Professional Skills
Full Hebrew Name (if known):
(Please write it in English letters - e.g. Baruch ben Dov v’Ruth or Sara bat Dov v'Ruth)
Are you a Cohen or Levi (if known)?
Cohen
Levi
Yisrael
None Set
B'/Bat/Bar Mitzvah date (if known:
Father's Hebrew Name (if known)
If you don't know your father's Hebrew name, you may type in his English name.
Mother's Hebrew name (if known):
If you don't know your mother's Hebrew name, you may type in her English name.
Other Adult Member Information (if applicable)
*For interfaith families, membership will be listed under the Jewish spouse.
First Name
Last Name
Please select preferred pronouns (optional)
He/Him/His
She/Her/Hers
They/Them/Their
Other
Email Address
This will be the email address used to log in to your Shulcloud account, our software database, and receive statements, announcements and the bulletin. Please choose an address checked regularly. You will receive instructions on how to login to your Shulcloud account after your membership has been approved.
Cell Phone
Primary Phone
This person prefers to be reached by...
Email
Phone Call
Text Message
Your Birthdate:
Marriage or Commitment Date, if known.
Volunteer and Professional Skills
Full Hebrew Name (if known):
(Please write it in English letters - e.g. Baruch ben Dov v’Ruth) or Sara bat Dov v'Ruth
Are you a Cohen or Levi (if known)?:
Cohen
Levi
Yisrael
None Set
B'/Bat/Bar MitzvahDate (if known):
Father's Hebrew name (if known):
If you don't know your father's Hebrew name, you may type in his English name.
Mother's Hebrew name (if known):
If you don't know your mother's Hebrew name, you may type in her English name.
Children (if applicable)
Please list the names of all children (20 years or younger) in your household, along with their birthdays (MM/DD/YY), school (or occupation, if no longer in school). One child per line.
Example: Peter Parker, 4/13/2012, Cinnabar School.
Yahrzeits (Anniversary of Passing)
As a courtesy for our members, BIJC sends out reminder letters a few weeks in advance of a Yahrzeit. Member Yahrzeits are also published in our weekly bulletin, and read from the bima on Shabbat. If you would like to receive these reminders, please fill out the box below according to the example shown.
You may give this information to the office at any time
Format: Name of deceased, date of death in MM/DD/YYYY, relationship to mourner. and mourner. One Yahrzeit per line. Note: The time of death (before or after sundown) is needed to determine the date of death on the Jewish calendar. If known, please indicate B for before sundown or A for after sundown.
Example: Benjamin Parker, 5/4/2017 B, uncle of Peter Parker,
Are you also a member of another Synagogue? (if applying for Associate Membership)
Synagogue Name
Location
Denomination, if known
How do you see yourself being involved and active at B'nai Israel Jewish Center?
Someone from the Center will contact you.
I would like to pay dues and other donations using
Check
Visa
Master Card
American Express
Cash
Erica Stuart, office administrator, will contact you if you want to use a credit card.
I would like to talk with someone about payment arrangements (Monthly, quarterly or other scheduled payments)
I would like to talk with someone about payment arrangements (Monthly, quarterly or other scheduled payments)
By checking this box, you will receive a call from Erica Stuart, our office administrator.
I/we are applying for membership. As a member of B'nai Israel Jewish Center, I/we agree to the payment of dues. My typed signature will indicate my permission charge my credit card for dues or other donations, if applicable.
*
Applicant Signature
*
Date
Applicant Signature
Tue, October 15 2024 13 Tishrei 5785