Membership

Surname (required)

Title (required)

Forename(s) (required)

Sex (required)

MF

Place of Birth (required)

Home Address (required)

Phone Number (required)

Your Email (required)

Hebrew Name (required)

Please copy and paste from below

Are you a...

CohenLevyYisroel

Previous Synagogue

If Single: Synagogue of Parent's Marriage

If Widowed/Divorced: Synagogue of Marriage

If Married

Date of Marriage

Synagogue of Marriage

Forename(s) of Spouse

Please list your childrens(s) names, genders and ages if under 18

Additional information (e.g. additonal email address)

Please note that before we accept your membership application we may have to ask you for some more information to clarify that you are eligible to become a member.

If you are single, then one of these bits of information will be a scan of your parents kesubo/ketubah. If you are or have been married then we will need to see your kesubo/ketubah. We can obtain this from you whilst we are processing your membership application so you do not need to have it to hand right now.

DECLARATION. To the best of my knowledge, the information given in this form is correct and forms the basis of my application for membership. I agree that, upon acceptance of this application I will abide by the Constitution of the Bristol Hebrew Congregation and will pay the subscriptions, where due, at the rate agreed with the Honorary Treasurer.

I agree with this declaration:

I consent that the Bristol Hebrew Congregation will retain my details as provided here, and these will not be shared with any other parties, or be used for any other purposes other than the BHC communicating with me.
I consent:

Date

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