Temple Emanuel Membership Application - Form - Temple Emanuel Winston-Salem

Shalom and thank you for your interest in Temple Emanuel! We are excited to welcome you into our Jewish community. Please take the time to fill out the application form below, and we will get back to you as soon as possible to follow-up.

If you haven't already, we recommend getting to know our temple a bit by taking a look around our website. Be sure to check out our LiveStream page to see what services are like here.

On behalf of everyone here at Temple Emanuel, we look forward to seeing you soon!

* First Name

Middle Name/Initial

* Last Name

Nickname

* Gender

Pronouns

(e.g. he/him, they/them)

* Address Line 1

Address Line 2

* City

* State

* Zip Code

Primary Phone Number

* Email Address

This is the email we will send confirmation info and important announcements to.

* I prefer to be contacted by...

* Date of Birth

* Marital Status

Anniversary

Occupation

Employer

* Are you new to the Winston-Salem area?

How long have you lived in Winston-Salem?

Where did you move from? (If applicable)

Anything else you'd like to share about yourself?

* I would like to be included in the membership directory.

I would like to be included in the membership directory.

Information for secondary adult member (if applicable):

First Name

Middle Name/Initial

Last Name

Nickname

Date of Birth

Phone Number

Email Address

* I prefer to be contacted by...

Occupation

Employer

Gender

Pronouns

Anything else you'd like to share about yourself?

* I would like to be included in the membership directory.

I would like to be included in the membership directory.

Primary Adult Member

Secondary Adult Member

* I am...

I am...

Hebrew Name

Father's Hebrew Name

Mother's Hebrew Name

Bar/Bat Mitzvah Date

Denomination I identify with most:

Which branch of Judaism did you grow up in, or feel most comfortable with? Temple Emanuel is a Reform congregation, but since we are the only synagogue in the vicinity, we have members of different backgrounds and denominations.

Denomination I identify with most:

Do you lead services?

If not, would you like to learn?

Do you read Torah?

Do you chant Haftarah?

Children Living at Home:
(skip this section if you do not have children)

First Child's Name

Nickname

* Gender

Pronouns

Date of Birth

Hebrew Name

Expected Bar/Bat Mitzvah Date

School

Current Grade

Second Child's Name

Nickname

* Gender

Pronouns

Date of Birth

Hebrew Name

Expected Bar/Bat Mitzvah Date

School

Current Grade

Additional Children/More Info About Children:

Children Not Living at Home:
(skip this section if you do not have children)

Child's Name

Nickname

* Gender

Pronouns

Current City, State

Other Information:
We encourage all members of the congregation to take an active part in Temple Emanuel Activities.
Which group/s of Temple Emanuel would you like to contact you? What interests you about Temple Emanuel?

Please use the left-hand column for the primary adult and the right-hand column for the secondary adult.

What was your involvement in your previous synagogue?

Where do you currently volunteer, and in what capacity?

Do you have any special skills/interests/abilities to share with us?

I hereby grant permission to Temple Emanuel to use photographs and/or video of my family members taken at Temple Emanuel activities onsite and offsite in publications, online, and in other communications related to Temple Emanuel.

YesNo

Please press the "Submit" button below to send your application to Temple Emanuel's Membership Committee. You should receive an email shortly that allows you to sign into the Temple Emanuel Shulcloud, where you can review your personal information and enter additional details, such as payment and yahrzeit information.