HNT Membership Application - Form - Herzl-Ner Tamid Conservative Congregation

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.

We ask that all prospective members meet (via Zoom or in-person) with Rabbi Herber. Please email Aviva Krause, Administrative Assistant, at Aviva@h-nt.org to schedule a time. Additionally, please fill out the form below and submit it at your earliest convenience. Upon completion of the form below, you will be prompted to set a password and login to your ShulCloud account. You must do this to complete the process.

* Number of Adults

Member 1

Title

* First Name

M.I.

* Last Name

Transliterated Hebrew Name (English letters, including parents' names)

* Gender

MaleFemaleOtherPrefer Not to Say

* Jewish?

YesNo

Tribe

KohenLeviYisrael

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

MaleFemaleOtherPrefer Not to Say

* Jewish?

YesNo

Tribe

KohenLeviYisrael

Conversion details (if applicable)

* Email Address

* Cell Phone

* Birth Date

Bar/Bat Mitzvah Date

Occupation and Location

Family Information

* Home Address

* City

* State

* Zip Code

Home Phone Number

Wedding Anniversary Date (month/day/year)

I/We would like to help HNT do our share to preserve the environment by receiving the monthly Hakol newsletter view email only.

Number of Children

NOTE: Upon completion of the form below, you will be prompted to set a password and login to your ShulCloud account. You must add your children to your ShulCloud account.

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?

Yahrzeit One

Name of Deceased

Transliterated Hebrew Name of Deceased

English Date of Death (month/day/year)

Time

Before SundownAfter 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)

Time

Before SundownAfter Sundown

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 SundownAfter 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 SundownAfter 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.

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 $250 per year.
• A Maintenance Assessment paid annually, currently $100 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 the form below, 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!