IMPORTANT:
CONTACT INFORMATION
* GenderPrefer Not To Answer Male Female
* 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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Marital Status Single Married Engaged Divorced Widowed Separated N/A Partnered
Please note that we have provided room for 3 Yahrzeits on this form. If you require more, you will be able to provide additional information once your form is submitted and your account is active.
Gender Prefer Not To Answer Male Female
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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Please note that we have provided room for 3 Yahrzeits on this form. If you require more, you will be able to provide additional information once your form is submitted and your account is active.
First Child
Gender Please Select One Male Female Gender Non-Conforming Prefer Not to Answer
Current Public School Grade Please Select One Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th College Not in school
Child is currently enrolled in the Rose Engel Early Childhood Center Please Select One Yes No
Child is currently enrolled in the Trana and Ronald Labowe Family Day School Please Select One Yes No
Child is currently enrolled in the Jewish Learning Community Please Select One Yes No
Has your child had a Bat/Brit Milah? Please Select One Yes No
Second Child
Gender Please Select One Male Female Gender Non-Conforming Prefer Not to Answer
Current Public School Grade Please Select One Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th College Not in school
Child is currently enrolled in the Rose Engel Early Childhood Center Please Select One Yes No
Child is currently enrolled in the Trana and Ronald Labowe Family Day School Please Select One Yes No
Child is currently enrolled in the Jewish Learning Community Please Select One Yes No
Has your child had a Bat/Brit Milah? Please Select One Yes No
Third Child
Gender Please Select One Male Female Gender Non-Conforming Prefer Not to Answer
Current Public School Grade Please Select One Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th College Not in school
Child is currently enrolled in the Rose Engel Early Childhood Center Please Select One Yes No
Child is currently enrolled in the Trana and Ronald Labowe Family Day School Please Select One Yes No
Child is currently enrolled in the Jewish Learning Community Please Select One Yes No
Has your child had a Bat/Brit Milah? Please Select One Yes No
Membership Commitment & Enrollment Information Suggested contribution levels are based around a "Sustaining Level," which is the average amount needed from each member household to sustain the operations, facilities, programs, and services at Adat Ari El. This excludes Adat Ari El schools, which will continue to remain funded primarily though tuition. The endowment remains independent.
Suggested Contribution Levels:
Contributing: $500 - $1,799Supporting: $1,800 - $2,799Sustaining: $2,800 - $3,599Cornerstone: $3,600 - $5,399Pillar: $5,400 - $7,199Benefactor: $7,200 - $9,999Guardian: $10,000 or more
Recognition on the Annual Giving Wall is offered to those who contribute at or above the Sustaining Level.
Under 5 - FREE Ages 6 - 26 – $18 Ages 27-29 - $75 Ages 30 and up - $100
Giving levels have been provided below. Please enter the exact amount you wish to pledge for membership in the space provided below each giving level. This section is required . If you do not enter an amount here, your membership form is not complete and we will follow up with you.
Payment Method Selection
* Please select a payment option below:Please Select One I/we will pay my/our pledge in full. I/we will make monthly installments with my/our first installment due today. If you opt to pay in installments, please note the maximum installment number is 10.
Please note: High Holy Day Tickets are no longer available - please contact the office at 818-766-9426 if you have any questions
I/We would be interested in starting: Please let us know if you are interested in starting or joining a program not already listed (for instance: mahjong, book club, hiking group, etc.) We will take your considerations into account when planning programming if we have enough interest.
I/we would be interested in volunteering Please Select One Yes No
I/we would be interested in joining a committee Please Select One Yes No
Chavurot
If you are currently in a Chavurah here at AAE, please let us know who else is affiliated: Please separate names with a comma
Adat Ari El Security Information
Emergency Contact Information
Primary Emergency Contact
* 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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Secondary Emergency Contact
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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Please note that you will only receive a vehicle sticker in the mail if you fill out information for each vehicle. We require license plate information. Additional vehicle sticker requests may be submitted to the office and we encourage you to call for assistance if you require additional stickers.
In applying for Adat Ari El membership, I agree to conform to the By-Laws and to honor all monetary pledges to the congregation. (If you would like a copy of the By-Laws sent to you via e-mail, please contact the office.)
Please sign electronically below:
I/We understand that all resignations from Adat Ari El MUST be received in writing by the administrative office no later than 30 days prior to the effective resignation date.
Please sign electronically below:
(818) 766-9426
(818) 766-9426