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Affiliate Membership Form

General Information

YOUR INFORMATION

Additional Family Information
Please include month and year of your child's birth date - for security's sake we default to the 1st of the month for the birth day
Please include month and year of your child's birth date - for security's sake we default to the 1st of the month for the birth day
Please include month and year of your child's birth date - for security's sake we default to the 1st of the month for the birth day
Please include month and year of your child's birth date - for security's sake we default to the 1st of the month for the birth day
Please include month and year of your child's birth date - for security's sake we default to the 1st of the month for the birth day
Please include month and year of your child's birth date - for security's sake we default to the 1st of the month for the birth day
Affiliate membership is only available to those members who retain full membership at another shul.
Tue, April 1 2025 3 Nisan 5785