Membership

בס”ד

SHIR HADASH MEMBERSHIP FORM

טופס הרשמה ל “שיר חדש”

2011-2012     תשע”ב

 _____________________________________________________________________________________________

NAME (include spouse’s full name as well if relevant)                             שם (+שם האישה/הבעל אם נחוץ

____________________________________________________________________________________________

CHILDREN’S NAMES (include ages as well)                                           שמות הילדים (כולל הגילאים)

______________________________________________________________________________________________

ADDRESS                                                                                                                                     כתובת

______________________________________________________________________________________________

PHONE (include all numbers)                                                                                           טלפון

______________________________________________________________________________________________

E-MAIL (include e-mails of family members)                                דואר אלקטרוני (כולל דוא”ל של שאר בני המשפחה)

 

Please indicate what type of membership you would like                          …       נא לציין איזה סוג של מנוי תרצו

 

_____        FAMILY MEMBERSHIP, includes Yamim Noraim seats for immediate family (1,000 NIS)

 

_____        COUPLES’ MEMBERSHIP, includes 2 Yamim Noraim seats (750 NIS)

 

_____        SINGLE MEMBERSHIP, includes 1 seat (500 NIS)

 

_____        ASSOCIATE MEMBERSHIP for those who participate in weekday programming only, such as the morning minyan, daf yomi or various evening classes (360 NIS)

 

_____        GAN FAMILY MEMBERSHIP is a complementary membership for families with a child in our gan program, includes seats for one’s immediate family (0 NIS)

 

_____                    ADDITIONAL SEATS for Yamim Noraim may be purchased by members for their out-of-walking-distance guests at 250 NIS for RH or YK, or 360 NIS for both.

 

Total # of Men’s seats_____ / Women’s seats _____                   מספר המושבים בעזרת הנשים ___ ובעזרת הגברים ____

 

Mail checks made out to Shir Hadash to: Shir Hadash / POB 8438 / German Colony / Jerusalem

 

Discounts on the above rates are available for anyone who requests, and can be confidentially acquired by e-mailing shirhadash613@gmail.com.  In addition, Tashlumim are gladly accepted.

 

.את הצ’קים יש לרשום לפקודת “שיר חדש”. ישנה אפשרות למספר תשלומים, עד 6  תשלומים

 

 

ADDITIONAL INFORMATION

 

Men: Name for Aliya _________________________________ / Are you ___ Cohen  ___ Levi  ___ Yisrael?

 

Women: Hebrew Name (include Mother & Father’s Name):______________________________________

 

Yahretziet for: _____________  [date & hebrew name]__________________________________________

Yahretziet for: _____________  [date & hebrew name]___________________________________________

Yahretziet for: _____________  [date & hebrew name]___________________________________________

Yahretziet for: _____________  [date & hebrew name]___________________________________________

 

Date of Aliyah: ______________________     Bar Mitzvah Parsha________________________________

Other special dates (Wedding anniversary, birthdays, bar/bat mitzvah)_______________________________ _______________________________________________________________________________________

 

www.shirhadash.com    shirhadash613@gmail.com     POB 8438 / Jerusalem

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