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HNT Membership Application
Please verify reCaptcha before submitting the form.
Thank you for your interest in membership at Herzl-Ner Tamid! Please fill out the following form so that we can better get to know you and process your application.
Upon completion, you will be prompted to set a password and login to your ShulCloud account. You must do this to complete the process.
If you have any questions during the process, please don't hesitate to reach out to our Director of Community Engagement, Cora Miller (
cora@h-nt.org
). We are looking forward to meeting you!
*
Number of Adults
Please Select One
1
2
Member 1
Title
*
First Name
M.I.
*
Last Name
Transliterated Hebrew Name (English letters, including parents' names)
*
Gender
Male
Female
Other
Prefer Not to Say
*
Jewish?
Yes
No
Tribe
Cohen
Levi
Yisrael
None Set
Conversion details (if applicable)
*
Email Address
*
Cell Phone
*
Birth Date
Bar/Bat Mitzvah Date
Occupation and Location
Member 2
Title
*
First Name
M.I.
*
Last Name
Transliterated Hebrew Name (English letters, including parents' names)
*
Gender
Male
Female
Other
Prefer Not to Say
*
Jewish?
Yes
No
Tribe
Cohen
Levi
Yisrael
None Set
Conversion details (if applicable)
*
Email Address
*
Cell Phone
*
Birth Date
Bar/Bat Mitzvah Date
Occupation and Location
Family Information
*
Home Address
*
City
*
State
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zip Code
Home Phone Number
Marital Status
Single
Married
Engaged
Divorced
Widowed
Separated
N/A
Partnered
Wedding Anniversary Date (if applicable)
I/We would like to help HNT do our share to preserve the environment by receiving the monthly Hakol newsletter via email only.
I/We would like to help HNT do our share to preserve the environment by receiving the monthly Hakol newsletter via email only.
Number of Children
Please Select One
N/A
1
2
3
4
5
6
NOTE: Upon completion of the form, when you are prompted to make an account, please go in and add your children.
Child 1
*
First Name
*
Last Name
Hebrew Name
*
Gender
Male
Female
Other
Prefer Not to Say
*
Birthdate
Time
Before Sundown
After Sundown
Child 2
*
First Name
*
Last Name
Hebrew Name
*
Gender
Male
Female
Other
Prefer Not to Say
*
Birthdate
Time
Before Sundown
After Sundown
Child 3
*
First Name
*
Last Name
Hebrew Name
*
Gender
Male
Female
Other
Prefer Not to Say
*
Birthdate
Time
Before Sundown
After Sundown
Child 4
*
First Name
*
Last Name
Hebrew Name
*
Gender
Male
Female
Other
Prefer Not to Say
*
Birthdate
Time
Before Sundown
After Sundown
Child 5
*
First Name
*
Last Name
Hebrew Name
*
Gender
Male
Female
Other
Prefer Not to Say
*
Birthdate
Time
Before Sundown
After Sundown
Child 6
*
First Name
*
Last Name
Hebrew Name
*
Gender
Male
Female
Other
Prefer Not to Say
*
Birthdate
Time
Before Sundown
After Sundown
Yahrzeit Information
(If you need assistance filling out this form, please call the synagogue office at 206-232-8555. If you have additional Yahrzeit dates, you will be able to add them into your ShulCloud account after completing this form.)
How many Yahrzeits do you have information for?
Please Select One
1
2
3
4
Yahrzeit One
Name of Deceased
Transliterated Hebrew Name of Deceased
English Date of Death (month/day/year)
Time
Before Sundown
After Sundown
Who is Yahrzeit Observer?
Deceased Relation to Observer?
Yahrzeit Two
Name of Deceased
Transliterated Hebrew Name of Deceased
English Date of Death (month/day/year)
Who is Yahrzeit Observer?
Deceased Relation to Observer?
Yahrzeit Three
Name of Deceased
Transliterated Hebrew Name of Deceased
English Date of Death (month/day/year)
Time
Before Sundown
After Sundown
Who is Yahrzeit Observer?
Deceased Relation to Observer?
Yahrzeit Four
Name of Deceased
Transliterated Hebrew Name of Deceased
English Date of Death (month/day/year)
Time
Before Sundown
After Sundown
Who is Yahrzeit Observer?
Deceased Relation to Observer?
If you would like information about a permanent Yarzheit Plaque for any of your departed loved ones, please visit h-nt.org/plaque or contact Aviva Krause at
Aviva@h-nt.org
or 206-232-8555 x208.
We want to get to know you!
Please use the questions in this section to tell us a little bit about yourself and your family.
Years in Seattle
Originally/Most Recently From
Previous Congregational Affiliations
Location
Dates
What did you particularly like/dislike about your previous synagogue experience?
What are your reasons for desiring synagogue membership?
What made you choose HNT as your home?
Do you have any talents or skills you would like to volunteer at the synagogue?
HNT has community groups based on shared interests (chavurot, affinity groups). What are your hobbies, passions, or interests?
In what Jewish organizations are members of your family currently active?
Are you interested in serving on any committees? If so, please indicate below.
Adult Education
Garinim (Young Families with children ages 0-7)
Ritual
Membership (Building community and welcoming new families)
Religious School
Social Action/Social Justice
Events and Programs - please indicate your interest below.
Administrative support or other occasional volunteer projects in the HNT office
Adult Education
Daytimers (Monthly lunch & a film for ages 55+)
Fundraising events
Garinim (Programs for young families with children ages 0-7)
Judaica shop volunteer staff
Men's Group
Minyanaires (A monthly Sunday Minyan featuring a little extra ruach and a friendly brunch)
Mitzvah Corps
Morning Minyan (Weekdays at 7:30 AM and Sundays and Secular Holidays at 9:00 AM)
Programming (Volunteer help for special events and holidays)
Shabbat Dinner Circle (Attending or hosting dinners with arranged groups)
Shabbat Greeter
Social Action Opportunities
Teen Feed (A monthly program providing hot meals for homeless youth in the U District)
Torah Readers
Women's League
HNTeens (High School)
I/We hereby accept membership in Herzl-Ner Tamid Conservative Congregation, and I/we promise to abide by HNT’s laws, customs and regulations that are now, or may thereafter, be in effect. I am aware that my photo may be used on occasion in HNT print and web images. I/We agree to pay the annual financial commitment in support of HNT’s programs and services as outlined in the
Annual Financial Commitment Fee Structure
.
I/We understand that the obligations of my/our membership in this congregation additionally to include the following:
• A Building Fund assessment in support of the needs, expenses, and future of our campus. This assessment is $300 per year, with a lifetime maximum of $3,600, payable beginning Year Two of membership.
• A Security Assessment paid annually, currently $500 per year.
• A Maintenance Assessment paid annually, currently $250 per year.
Upon submission, you will be directed to our Annual Commitment Form, which will allow you to select your appropriate dues level or request financial mitigation. You will also receive a link to the form in your inbox.
Lastly,
Upon completion of your application, you will be prompted to set a password and login to your ShulCloud account. You must do this to complete the process. Please add all children to your account, if applicable.
Thanks, and we look forward to welcoming you into the HNT family soon!
Thu, October 3 2024
1 Tishrei 5785
Thu, October 3 2024 1 Tishrei 5785
