Congregation Schara Tzedeck - Membership Application

Name:
Hebrew Name:	ben/bat
If male, please indicate Kohen Levi or Israel:
	Kohen_Levi Israel
Address:
City:
	Province: Postal Code:
Phone:
Fax:
Email:
Business Name:
Business Phone:
Place of birth:
Date of birth:
Place of Marriage:
Date of Marriage:

Anniversaries/Yahrtzeits Observed
Name	Date of Death	Relationship to deceased

Are you interested in joining a committee
and becoming involved in activities at the shul? Yes No

Life Cycle