CONGREGATION AHAVAS CHESED
705 Regents Way
Mobile, AL 36609
251/343-6010 Telephone 251/343-6449 FAX
Application for Membership
(Please print)
Family Name _________________________Marital Status ___________ Date of Marriage ____________
Home Address ____________________________ Zip Code ____________ Phone __________________
Former Home Address __________________________________________________________________
Former Synagogue/Temple Affiliation _______________________________________________________
Type of Membership: ___ Single ___ Couple ___ Family ___ Associate
____________________________________________________________________________________
Adult Male _________________________________________________ Date of Birth _______________
Hebrew Name _________________________ ben ___________ Please circle one: Kohein, Levi, Yisroel
Place of Employment _________________________________________ Phone _____________________
Position _____________________________________________________________________________
Adult Female _______________________________________________ Date of Birth _________
Hebrew Name _________________________ bat ___________ Please circle one: Kohein, Levi, Yisroel
Place of Employment _________________________________________ Phone _________________
Position _________________________________________________________________________
Children Hebrew name Date of Birth
_______________________________________________________________________________
Adult male Adult Female
Religious Traditions
(Please Circle) Conservative Conservative
Reform Reform
Orthodox Orthodox
Jewish, Non-Practicing Jewish, Non-Practicing
Non-Jewish Non-Jewish
Date Application completed ______________________________ Veteran? Yes ___ No ___
MEMBERSHIP APPLICATION
(CONTINUED)
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YARTZEIT INFORMATION
Please complete the following Yartzeit Information which will enable us to notify you when the Hebrew Yartzeit will occur.
Traditionally, we read the names of deceased family members at the Shabbat immediately before the Yartzeit. It is an appropriate time to attend services and recite the Kaddish prayer. If a weekday Yartzeit Minyan is desired, please contact Rabbi Silberman at least two weeks prior to the date to arrange for this Minyan.
Name of Deceased Relationship Date of Death*
English ___________________________________________________________________________
Hebrew ____________ (ben/bat) _______________________________________________________
* If the Hebrew date is not known, please state the approximate time of death, i.e. day or night, before