Congregation B'nai Israel Membership Application

We are delighted that you are choosing to be part of our community. Please complete this form. This information enables us to to find ways to enrich your experience with us. All information will be treated in a confidential and respectful manner. Your information will only be shared with the appropriate staff
and committee chairs.

If you have any questions or concerns as you complete the application, please contact Leslie Oberst, Executive Director at execdir@bnais.com.

FAMILY AND MAILING INFORMATION

* Name(s) to be used for mailings

* Mailing Address

* City

* State

* Zip Code

Household Status:

Please select the one that best applies

Anniversary Date:

Interfaith:

Please Select OneYesNo

* We want to get to know you and make sure we meet the needs of our members. Please use the space below to share what brought you to CBI.

We have several email options to enable you to stay connected with CBI activities. We will email each of these to you unless you opt out. Please indicate if you would like to OPT OUT of any of the following:

The Chadashot: a weekly summary of upcoming events and activitiesOther members' life cycle notices (births, deaths, etc.)Adult Education classesSocial Justice eventsThe Koleinu: the CBI newsletter is distributed by email (automatically)

ADULT APPLICANT 1

* First Name

* Last Name

* Please check all that apply:

MaleFemaleNon-BinaryOther

Preferred Pronoun

Hebrew Name (if known or applicable):

Transliteration is preferred

* Birth Date:

* Best phone number to reach you at:

* E-mail:

* Occupation/Title

Religious Background:

Please indicate below what tradition or religion best fits.

If you converted to Judaism, what city, congregation and date?

If you had a bar/bat mitzvah, what city, congregation and date?

If you were confirmed in the Jewish faith, what city, congregation and date?

Do you read Hebrew?

YesNo

Do you chant Torah?

YesNo

Were you previously a member of CBI? If so, when?

If you have relatives at CBI, who are they and what is their relationship to you?

ADULT APPLICANT 2

First Name

Last Name

Please check all that apply:

MaleFemaleNon-BinaryOther

Preferred Pronoun

Hebrew Name (if known or applicable):

Transliteration is preferred

Birth Date:

Cell Phone:

E-mail:

Occupation/Title

Religious Background:

Please indicate below what tradition or religion best fits.

If you converted to Judaism, what city, congregation and date?

If you had a bar/bat mitzvah, what city, congregation and date?

If you were confirmed in the Jewish faith, what city, congregation and date?

Do you read Hebrew?

YesNo

Do you chant Torah?

YesNo

Were you previously a member of CBI? If so, when?

If you have relatives at CBI, who are they and what is their relationship to you?

CHILDREN INFORMATION

* How many children are in your household?

Please indicate only those who are minors or are claimed dependents,

Child 1

First Name

Last Name

Please check all that apply:

MaleFemaleNon-BinaryOther

Preferred Pronoun

Hebrew Name (if known or applicable):

Transliteration is preferred

Birth Date:

Cell Phone:

E-mail:

Is this child being raised in the Jewish faith?

Please Select OneYesNo

Is this child attending Shalom School?

Please Select OneYesNo

Name of/grade in secular school or college?

B'nai Mitzvah date, congregation, city:

Confirmation date, congregation, city:

Child 2

First Name

Last Name

Please check all that apply:

MaleFemaleNon-BinaryOther

Preferred Pronoun

Hebrew Name (if known or applicable):

Transliteration is preferred

Birth Date:

Cell Phone:

E-mail:

Is this child being raised in the Jewish faith?

Please Select OneYesNo

Is this child attending Shalom School?

Please Select OneYesNo

Name of/grade in secular school or college?

B'nai Mitzvah date, congregation, city:

Confirmation date, congregation, city:

Child 3

First Name

Last Name

Please check all that apply:

MaleFemaleNon-BinaryOther

Preferred Pronoun

Hebrew Name (if known or applicable):

Transliteration is preferred

Birth Date:

Cell Phone:

E-mail:

Is this child being raised in the Jewish faith?

Please Select OneYesNo

Is this child attending Shalom School?

Please Select OneYesNo

Name of/grade in secular school or college?

B'nai Mitzvah date, congregation, city:

Confirmation date, congregation, city:

Child 4

First Name

Last Name

Please check all that apply:

MaleFemaleNon-BinaryOther

Preferred Pronoun

Hebrew Name (if known or applicable):

Transliteration is preferred

Birth Date:

Cell Phone:

E-mail:

Is this child being raised in the Jewish faith?

Please Select OneYesNo

Is this child attending Shalom School?

Please Select OneYesNo

Name of/grade in secular school or college?

B'nai Mitzvah date, congregation, city:

Confirmation date, congregation, city:

RELIGIOUS SCHOOL ENROLLMENT

* How many children will be attending CBI Religious School this year?

Congregation B'nai Israel is committed to never denying a Jewish education. Below are the tuition fees for our Religious School, Tuesday Hebrew School and Kesher Programs, including Confirmation.

Grade	Annual Tuition
K’tonton (members rate)	$280
Pre K – 3^rd grade and 7^th grade	$480
4^th – 6^th grade	$720
8^th – 9^th grade	$360
10^th grade (includes Confirmation)	$635
11^th – 12^th grade	$220

Scholarship are available; please click here to apply

First Name

Please select which grade you are enrolling your child in

First Name

Please select which grade you are enrolling your child in

First Name

Please select which grade you are enrolling your child in

First Name

Please select which grade you are enrolling your child in

YAHRZEIT INFORMATION

As a member, Congregation B'nai Israel will send you reminders of your loved ones' Yahrzeit dates. You will receive a reminder several weeks in advance of an upcoming Yahrzeit. Names of the departed are read during the Friday evening and Saturday morning Shabbat service following the anniversary of death.

Do you have Yahrzeits you would like recorded?

Which date would you like to observe?

Please Select OneSecularHebrew

How would you like to receive the reminder?

Please Select OneE-mail notificationMailed letter

Please use the fields below for your beloved one's Yahrzeits.

Name:

Family Relationship:

Date of death:

Name:

Family Relationship:

Date of death:

Name:

Family Relationship:

Date of death:

Name:

Family Relationship:

Date of death:

Name:

Family Relationship:

Date of death:

Name:

Family Relationship:

Date of death:

Please use the space below, if needed, for additional Yahrzeits.

CEMETERY INFORMATION

Do you own a cemetery plot, mausoleum, crypt, or niche?

Please Select OneYesNo

Please indicate the location:

Would you like information about Home of Peace, the Jewish cemetery in Sacramento?

YesNo

ADDITIONAL INFORMATION

PHOTO/VIDEO RELEASE: I acknowledge that Congregation B’nai Israel is responsible for producing and publishing a variety of newsletters, brochures, videos, flyers and social media publicity. I also understand some educational sessions may take place online and be recorded. I hereby authorize CBI to use, reproduce or publish photographs or videos of my family, including children, which may be taken during our participation in services, programming, or religious school and educational activities for any purposes without compensation to me or my child/children.

I agree to the CBI Photo and Video Release

Please Select OneYesNo

Is there anything else you would like to tell us?

MEMBERSHIP COMMITMENT

We appreciate our members' generous contribution of time, talent and financial support that enables CBI to keep Judaism meaningful, vibrant, and relevant in our community and daily lives.

Your financial support is a necessary ingredient to sustain our wonderful traditions. It is our commitment to never refuse membership based on finances or deny a child a Jewish education because of family’s lack of financial resources. We ask only that you be intentional about your ability to contribute. Every congregant who makes a sincere pledge in any amount is a valued member of our congregation.

Below are the suggested 2023-2024 annual membership commitment levels.

Nasim (Leaders)	$8,000
Giborim (Heros)	$7,000
Malachim (Angels)	$6,000
T’zadikim (Righteous Ones)	$5,000
Shomrim (Guardians)	$4,000
Bonim (Builders)	$3,500
Family Membership	$3,250 (Religious School Tuition is additional)
Single Membership	$2,280
Senior Family (Limited Income)	$1,750
Senior Single (Limited Income)	$1,380
*Associate Member	$575
*Friends of CBI Membership	$180

Visit www.cbisacramento.org/membership for membership details.

We ask each membership household to make an annual financial commitment. Our membership year is July 1 - June 30. Payments can be made over the year or in one payment. We ask that the commitment is paid by June 30, unless arrangements are made with the Executive Director.

No person will be denied membership based on financial resources. All conversations regarding finances are strictly confidential.

Also, a reminder if you are current with your membership commitment, you may gift a free membership for one year to a family or individual who is not currently a member of, or affiliated with, another congregation. That membership will include tickets to the High Holy Days.

Please select your membership commitment below.

Other:

Please enter in an amount that works for your household.

Notes:

Please indicate who is gifting your household a membership

Beginning in the second year of membership, each CBI member household is assessed a Building Fund Pledge amounting to 1 ½ times the initial membership commitment. This amount is spread over five years. The Building Fund is specifically for the ongoing maintenance and repairs of our buildings.

THANK YOU FOR YOUR INTEREST IN JOINING OUR CBI COMMUNITY

Total Annual Membership Commitment and Religious School and Kesher Fees, as applicable

We ask that financial commitments are paid by June 30, unless arrangements are made with the Executive Director.

On the next page, you will have the option to make a payment, either partial or full, set-up recurring payments or post to your membership account for payment at a later date.

CONGREGATION B'NAI ISRAEL

Keeping Tradition, Moving Forward

Today's Calendar

Friday Night

Shabbat Day

Upcoming Programs & Events

This week's Torah portion is Parashat Vayeishev

Erev Hanukkah

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