Synagogue Member Record 2025 - Form - Congregation Etz Chaim

Join Date

Martial Status

If Married, Wedding Anniversary Date

Address

City

State

Zip

Is this membership for one or two people

Prefix

Pronouns

Home Number

* Full Name

* Nickname

* Date of Birth

Cell Number

Instagram

Facebook

Occupation

Business Name

Work Phone

Work Email

Years in Atlanta

Hometown

Prior Synagogue, Location, Date of Membership, and Position Held

Hebrew Name

Bar/Bat Mitzvah

Bar/Bat Mitzvah Date

Mother's Hebrew Name

Father's Hebrew Name

Tribe Name

Please select one:KohenLeviteIsraelite

Were you born Jewish

If converted, date, by whom, and where

Can you read Hebrew

Do you have any relatives at Etz Chaim

If so, please list with relationship

How many children

Child(ren) Name

Sex

Date of Birth

Adopted

School Grade

Jewish Day School

Hebrew Name

Bar/Bat Mitzvah Date

Yahrzeits Observed

Full Name of Deceased

Relationship to Deceased

Mourner of Deceased

Secular Date of Death (MM/DD/YY) Before or After Sunset

Would you like to be a "featured new member" in our monthly newsletter, the Voice of Chaim?

YesNo(someone from our membership committee will reach out to you.)

What would like to get from Etz Chaim?

What would you like to give to Etz Chaim?

Areas of interest you would like more information?

We look forward to receiving your information. If you have any questions, please contact us at (770) 973-0137.