The Forest Hills Jewish Center 106-06 Queens Boulevard, Forest Hills, ny 11375 Membership Application



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The Forest Hills Jewish Center

106-06 Queens Boulevard, Forest Hills, NY 11375

Membership Application
I/We apply for membership in Forest Hills Jewish Center and agree to abide by its By-Laws

PLEASE PRINT IN INK AND FILL IN THIS FORM FOR OUR DATABASE
__________________________________ ________________________________

Male Member Female Member

_____________________________________ ___________________________________

Hebrew Name Hebrew Name

_____________________________________ ___________________________________

Address Address

_____________________________________ ___________________________________

City Zip City Zip

_____________________________________ ___________________________________

Home Phone Bus. Phone Home Phone Bus. Phone

_____________________________________ ___________________________________

E-mail Address Bus. Fax E-mail Address Bus. Fax

_____________________________________ ___________________________________

D.O.B. Blood Type D.O.B. Blood Type

_____________________________________ ___________________________________

Occupation Occupation

_____________________________________ ___________________________________

Company Company

_____________________________________ ___________________________________

Address Address


___________________________________

For couples: Anniversary Date

_______ _______ _______ _______ _______ _______

Kohen Levi Yisroel Kohen Levi Yisroel


Previous Association with FHJC? Yes____ No____ Dates: ____________________
Related to other members? Yes____ No____ If yes, name and Relationship_____________________________

Member Household: (Check all that apply)

___ number of children

___ has only adult children (ages over 21)

___ has children who will be participating in our religious school

___ has children who will be participating in our youth group

___ has children who will become Bar/Bat Mitzvah in the next ___ year(s)

___ has children who will be married in the next ___ month (s)

___ is a single parent family

___ is widowed, divorced

___ is single
The Forest Hills Jewish Center is a Conservative Synagogue. The Toddler Program, Nursery School and Kindergarten Program

and Religious School are open to Jewish children only. A Jewish child is one who is born of a Jewish Mother or who has

undergone a conversion in accordance with the standards of the Conservative movement. If you have questions regarding

the religious status of your child due to adoption or conversion, we request that you discuss it with Rabbi Skolnik. Non- Jewish parents are always welcome in our synagogue and in our schools, but may not participate in the Synagogue rituals except on

the day of the bar/bat mitzvah of his/her child at which time a non-Jewish parent may choose to read the Prayer for our

Country, or the Prayer for America’s Military Personnel.


Signature (s) of Member (s) ________________________________ Date___________________________
Membership Chair/Executive Director_________________________ Date___________________________

Children: (Please print name in full)

__ I/We request registration information on Religious School. (Kindergarten to High School)
__ I/We request registration information on Toddler programs. (Age 22 mos. to 36 mos.)
__ I/We request registration information on Nursery School programs. (Age 3 to 5 years)
Youth Groups:

__ Tseerim (Grades 4 & 5)

__ Kadima (Grades 6, 7 & 8)
__ U.S.Y. (Grades 9, 10, 11 & 12)
_________________________________________ ____________________________________

Name Sex Date of Birth Bar/Bat Mitzvah Date

____________________________________________________________________________________

School/College Grade/Year E-mail Address



College Address________________________ City ________________________ State_____ Zip______

_______________________________________ ______________________________________

Name Sex Date of Birth Bar/Bat Mitzvah Date

______________________________________________________________________________________

School/College Grade/Year E-mail Address


College Address________________________ City ________________________ State_____ Zip_______

_______________________________________ ______________________________________

Name Sex Date of Birth Bar/Bat Mitzvah Date

______________________________________________________________________________________

School/College Grade/Year E-mail Address


College Address_______________________ City_______________________ State_____ Zip__________
______________________________________________________________________________________

Name Sex Date of Birth Bar/Bat Mitzvah Date

______________________________________________________________________________________

School/College Grade/Year E-mail Address



YAHRZEIT INFORMATION
Please list any name and dates for which you would like to receive information

English Name: ___________________________________________________


Hebrew Name: ___________________________________________________
English Date of Death: ________________ Hebrew Date of Death: _________
Before Sundown: _____________________ After Sundown: _______________
Relationship to Deceased: ___________________________________________

English Name: ___________________________________________________


Hebrew Name: ___________________________________________________
English Date of Death: ________________ Hebrew Date of Death: _________
Before Sundown: _____________________ After Sundown: _______________
Relationship to Deceased: ___________________________________________

English Name: ____________________________________________________


Hebrew Name: ____________________________________________________
English Date of Death: ________________ Hebrew Date of Death: __________
Before Sundown: _____________________ After Sundown: ________________
Relationship to Deceased: ____________________________________________

CEMETERY PRIVILEGES

An additional fee of $15.00 per year entitles a member to an individual gravesite

in the Center Cemetery section at New Montefiore Cemetery, Pine Lawn, Long Island

for the internment of a member’s immediate family member. Additional adjacent plots



may be reserved at the time of the first internment, at a cost of $1000 each.

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