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MJC Membership Application
Please verify reCaptcha before submitting the form.
Please complete the application below. If you have any questions, please call the office at (516) 379-8650 or email
execdir@merrickjc.org
.
Primary Member 1
First Name
Last Name
Date of Birth
Address
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
Home Phone
Cell Phone
Email Address
Marital Status
Single
Married
Engaged
Divorced
Widowed
Separated
N/A
Partnered
If married, Anniversary date
Do you have any children?
Yes
No
If yes, please list names and dates of birth.
Occupation/Position
Business Name/Address
Business Phone
Business Fax
Business Email
Hebrew Name
Tribe
Cohen
Levi
Yisrael
None Set
Previous Jewish Education/Experience/Involvement in Jewish Organizations (i.e. Hillel)
Previous Synagogue Affiliation
Orthodox
Reconstructionist
Conservative
Reform
Name of Synagogue and Dates of Affiliation
I would like to know more about the following activities
Adult Education: Plans courses, programs and educational outings.
Budget & Finanace: Monitors the finanancial condition of the Temple, advises the treasurer, assists in preparation fo the annual budget.
Bulletin: Quarterly publication that chronicles holidays, special events, activities and news of the synagogue.
Chesed: Makes possible "acts of loving kindness" on behalf of the congregation to mourners and others in need of assistance.
Fundraising: Plans events and programs intended to raise addtional funds for the congregation.
House: Coordingates the maintenance of our building and property.
JCC Liason: Facilitates communications between the JCC, the school and the synagogue regarding each other's events and programming.
Kol Nidre: Major annual fundraising drive occurring during the High Holy Days season.
Legal: Provides legal advice and draws up and reviews legal documents as necessary.
Membership: Disseminates information about our synagogue to protential members and welcomes new members through outreach.
Men's Club: Provides social, cultural and educational opportunities for men of our congregation, as well as for the entire congregation.
Minyan Club: Supports early morning minyanmim held Monday-Thursday and Sunday as well as evening minyanim.
PTO: Acts as liason between parents and the Hebrew school, and supports the school through fundraising events.
Ritual: In consultation with the clergy, considers matters affecting the religious life of the congregation.
School Board: Sets policy, and oversees and administers the operations of the school.
Sisterhood: Sponsors activities and events that promote Jewish values and support the social, educational, cultural and charitable interests of the membership.
Technology: Reviews and advises as to the synagogue's current and future technological requirements.
Tickets: Disseminates High Holy Day tickets and materials. Advises as to policies concerning tickets.
UJA: Supports UJA locally and in Israel. Plans and presents an annual event in support of UJA and the synagogue.
Youth: Gives direction to and assists the Youth Advisors in carrying out a wide variety of youth group activities.
Primary Member 2
First Name
Last Name
Date of Birth
Address
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
Home Phone
Cell Phone
Email Address
Marital Status
Single
Married
Engaged
Divorced
Widowed
Separated
N/A
Partnered
If married, Anniversary date
Occupation/Position
Business Name/Address
Business Phone
Business Fax
Business Email
Hebrew Name
Tribe
Cohen
Levi
Yisrael
None Set
Previous Jewish Education/Experience/Involvement in Jewish Organizations (i.e. Hillel)
Previous Synagogue Affiliation
Orthodox
Reconstructionist
Conservative
Reform
Name of Synagogue and Dates of Affiliation
I would like to know more about the following activities
Adult Education: Plans courses, programs and educational outings.
Budget & Finanace: Monitors the finanancial condition of the Temple, advises the treasurer, assists in preparation fo the annual budget.
Bulletin: Quarterly publication that chronicles holidays, special events, activities and news of the synagogue.
Chesed: Makes possible "acts of loving kindness" on behalf of the congregation to mourners and others in need of assistance.
Fundraising: Plans events and programs intended to raise addtional funds for the congregation.
House: Coordingates the maintenance of our building and property.
JCC Liason: Facilitates communications between the JCC, the school and the synagogue regarding each other's events and programming.
Kol Nidre: Major annual fundraising drive occurring during the High Holy Days season.
Legal: Provides legal advice and draws up and reviews legal documents as necessary.
Membership: Disseminates information about our synagogue to protential members and welcomes new members through outreach.
Men's Club: Provides social, cultural and educational opportunities for men of our congregation, as well as for the entire congregation.
Minyan Club: Supports early morning minyanmim held Monday-Thursday and Sunday as well as evening minyanim.
PTO: Acts as liason between parents and the Hebrew school, and supports the school through fundraising events.
Ritual: In consultation with the clergy, considers matters affecting the religious life of the congregation.
School Board: Sets policy, and oversees and administers the operations of the school.
Sisterhood: Sponsors activities and events that promote Jewish values and support the social, educational, cultural and charitable interests of the membership.
Technology: Reviews and advises as to the synagogue's current and future technological requirements.
Tickets: Disseminates High Holy Day tickets and materials. Advises as to policies concerning tickets.
UJA: Supports UJA locally and in Israel. Plans and presents an annual event in support of UJA and the synagogue.
Youth: Gives direction to and assists the Youth Advisors in carrying out a wide variety of youth group activities.
In consideration of my (our) election to membership at Merrick Jewish Centre, I (we) agree to pay all charges for dues, building fund, school tuition, Bar/Bat Mitzvah fees and assessments upon receipt of a statement from the synagogue. Annual dues are billed and payable in July of each year. Arrangements for monthly and quarterly dues must be made in advance with the Finance Committee. I (we) understand that no High Holy Day tickets will be distributed or school admission card given unless my (our) account is current. Membership is continuous unless Merrick Jewish Centre is notified in writing of a resignation. I (we) hereby apply for membership in Merrick Jewish Centre.
Please check the box(es) below to indicate you have read the statement above and agree to it.
Primary Member 1
Primary Member 2
Sat, April 26 2025 28 Nisan 5785
