Chavurah Interest Form

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Primary Member on Account

* Last Name

* First Name

* Birthday

* Cell Phone Number

* Email

Profession

Hometown

Secondary Member on Account (if Applicable)

Last Name

First Name

Birthday

Cell Phone Number

Profession

Hometown

Street Address

* City

Zip Code

* Marital Status

Please Select OneSingleMarriedDivorced/SeparatedWidowed

What year did you join Temple Emanu-El?

How many children do you have

#1 Child Last Name

#1 Child First Name

#1 Child Birthday (MM/DD/YYYY)

#1 Child School

#2 Child Last Name

#2 Child First Name

#2 Child Birthday (MM/DD/YYYY)

#2 Child School

#3 Child Last Name

#3 Child First Name

#3 Child Birthday (MM/DD/YYYY)

#3 Child School

#4 Child Last Name

#4 Child First Name

#4 Child Birthday (MM/DD/YYYY)

#4 Child School

#5 Child Last Name

#5 Child First Name

#5 Child Birthday (MM/DD/YYYY)

#5 Child School

#6 Child Last Name

#6 Child First Name

#6 Child Birthday (MM/DD/YYYY)

#6 Child School

* What are your/your family's Chavurah interests & lifestyle?

Active/Outdoor ActivitiesJewish Life/Shabbat/HolidaysActivities with ChildrenSocial Events (i.e., Bowling, skating, restaurants)Other

If Other, please explain.

* What are your/your family's Temple-related interests?

BrotherhoodSisterhoodCaring CommitteeSocial JusticeLife Long LearningOther

If Other, please explain.

* What else is important to you in joining a Chavurah (e.g. strong likes/dislikes, important family dynamics or background, etc.)?nt to share, etc.)?

* Are there specific members that you would like to be in a Chavurah with? Are there specific members you would NOT like to be in a Chavurah with?

Sun, April 28 2024 20 Nisan 5784

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