Information form

Who does this form relate to?
-Individual (Jewish)Individual (interested in converting)Individual (non-Jewish)Couple (both Jewish)Couple (mixed)Couple (interested in converting)Couple (non-Jewish)Family (Jewish)Family (Mixed)Family (interested in converting)Family (non-Jewish)

Your name

Name of any partner

Name and years of birth of any children

Your email

Your phone number

Your address

Are you or have you previously been a member of another Jewish community or synagogue? If so, which one(s):

Any additional message (optional) including any yahrzeits you wish us to be aware of

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