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Membership Application
Please verify reCaptcha before submitting the form.
We are thrilled that you are joining Peninsula Temple Sholom. Before completing this form, you have probably talked with a member of our staff who shared with you this link. If not, and you have questions, please contact Karen Wisialowski, Chief Community Officer, at cco@sholom.org.
Per PTS bylaws:
a) Any adult who (i) identifies as Jewish or is a member of a Household that includes or previously included anyone who identifies as Jewish, (ii) seeks to be associated with a Jewish faith community, and (iii) supports PTS’s vision, mission, and values, may be admitted as a member of the Congregation (a "Member") upon approval of the Board (as defined in Article VIII, Section 8) in accordance with policies adopted from time to time by the Board.
As you complete the form below, additional screens will pop open as needed. You will receive a confirmation email after you make your final submission.
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Address
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City
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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
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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Zip Code
Landline
Emergency Contact Name
Emergency Contact Phone Number
Emergency Contact Relationship
*
Are you new to the area?
Please Select One
Yes
No
*
Adult 1 - Title
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Adult 1 - First Name
*
Adult 1 - Last Name
Adult 1 - Nick Name
*
Adult 1 - Date of Birth
*
Adult 1 - Are you Jewish?
Please Select One
Yes
No
Adult 1 - Hebrew Name
Adult 1 - Father's Hebrew Name
Adult 1 - Mothers's Hebrew Name
*
Adult 1 - Tell us about your Jewish history
*
Adult 1 - Tell us what you are hoping to gain from membership
Adult 1 - Occupation
Adult 1 - Business Name
*
Adult 1 - Preferred Phone
*
Adult 1 - Preferred Email
We are glad that you are joining the PTS Community. Let us know a little more about your interests and talents in the section below. We want to help you make connections at PTS. Please let us know how we can help!
Worship
Adult Learning
Social Events
Social Action/Social Justice
Caring for our Members
Youth Programming
Musical Events
Film
Israel
Volunteering in the Office
Sholom Women
Youth Education
League of Extraordinary Mensches
Preschool
Adult 1 - Do you have special skills?
Computer
Website
Video
Budget/Finance
Event Planning
Chanting Torah
*
Marital Status?
Single
Married
Engaged
Divorced
Widowed
Separated
N/A
Partnered
Anniversary, if married
Adult 1 - Are you a Veteran?
Please Select One
Yes
No
*
Is there a second adult/head of household in your family?
Please Select One
Yes
No
*
Adult 2 - Title
*
Adult 2 - First Name
*
Adult 2 - Last Name
Adult 2 - Nick Name
*
Adult 2 - Date of Birth
*
Adult 2 - Is the second adult Jewish?
Please Select One
Yes
No
Adult 2 - Hebrew Name
Adult 2 - Father's Hebrew Name
Adult 2 - Mothers's Hebrew Name
Adult 2 - Tell us about the second adult's Jewish history
Adult 2 - Tell us what the second adult is hoping to gain from membership
Adult 2 - Occupation
Adult 2 - Business Name
*
Adult 2 - Preferred Phone
*
Adult 2 - Preferred Email
We are glad that the second adult is joining the PTS Community. Let us know a little more about the second adult's interests and talents in the section below. We want to help the second adult make connections at PTS. Please let us know how we can help!
Worship
Adult Learning
Social Events
Social Action/Social Justice
Caring for our Members
Youth Programming
Musical Events
Film
Israel
Volunteering in the Office
Sholom Women
Youth Education
League of Extraordinary Mensches
Preschool
Adult 2 - Do you have special skills?
Computer
Website
Video
Budget/Finance
Event Planning
Chanting Torah
*
Adult 2 - Are you a veteran?
Please Select One
Yes
No
*
How many children ages 29 and under live in your home?
Please Select One
One child
Two Children
Three Children
Four Children
Five Children
none
*
Child 1 - First Name
*
Child 1 - Hebrew Name
*
Child 1 - Last Name
*
Child 1 - Gender Identity
*
Child 1 - Birth Date
*
Child 2 - First Name
*
Child 2 - Hebrew Name
*
Child 2 - Last Name
*
Child 2 - Gender Identity
*
Child 2 - Birth Date
*
Child 3 - First Name
*
Child 3 - Hebrew Name
*
Child 3 - Last Name
*
Child 3 - Gender Identity
*
Child 3 - Birth Date
*
Child 4 - First Name
*
Child 4 - Hebrew Name
*
Child 4 - Last Name
*
Child 4 - Gender Identity
*
Child 4 - Birth Date
*
Child 5 - First Name
*
Child 5 - Hebrew Name
*
Child 5 - Last Name
*
Child 5 - Gender Identity
*
Child 5 - Birth Date
*
Names of those who have died and for whom you observe Yahrzeit. Kaddish will be recited at the Shabbat immediately following the anniversary date. How many Yahrzeits would you like to remember?
Please Select One
One yahrzeit
Two yahrzeits
Three yahrzeits
Four yahrzeits
Five yahrzeits
Six yahrzeits
none
Name
Hebrew Name
*
Related to
Please Select One
Adult 1
Adult 2
Relationship
English Date of Death
Hebrew Date of Death
Before or After Sunset
Please Select One
Before Sunset
After Sunset
Not sure
Do you prefer to observe the English Date or the Hebrew Date?
Please Select One
English Date
Hebrew Date
Name
Hebrew Name
*
Related to
Please Select One
Adult 1
Adult 2
Relationship
English Date of Death
Hebrew Date of Death
Before or After Sunset
Please Select One
Before Sunset
After Sunset
Not sure
Do you prefer to observe the English Date or the Hebrew Date?
Please Select One
English Date
Hebrew Date
Name
Hebrew Name
*
Related to
Please Select One
Adult 1
Adult 2
Relationship
English Date of Death
Hebrew Date of Death
Before or After Sunset
Please Select One
Before Sunset
After Sunset
Not sure
Do you prefer to observe the English Date or the Hebrew Date?
Please Select One
English Date
Hebrew Date
Name
Hebrew Name
*
Related to
Please Select One
Adult 1
Adult 2
Relationship
English Date of Death
Hebrew Date of Death
Before or After Sunset
Please Select One
Before Sunset
After Sunset
Not sure
Do you prefer to observe the English Date or the Hebrew Date?
Please Select One
English Date
Hebrew Date
Name
Hebrew Name
*
Related to
Please Select One
Adult 1
Adult 2
Relationship
English Date of Death
Hebrew Date of Death
Before or After Sunset
Please Select One
Before Sunset
After Sunset
Not sure
Do you prefer to observe the English Date or the Hebrew Date?
Please Select One
English Date
Hebrew Date
Name
Hebrew Name
*
Related to
Please Select One
Adult 1
Adult 2
Relationship
English Date of Death
Hebrew Date of Death
Before or After Sunset
Please Select One
Before Sunset
After Sunset
Not sure
Do you prefer to observe the English Date or the Hebrew Date?
Please Select One
English Date
Hebrew Date
We are thrilled that you are joining Peninsula Temple Sholom community. We count on your membership to support our community - daily operations, programs and activities - and ask that you support PTS to the best of your ability.
Please select a membership commitment level (Tuition is additional):
Please Select One
Tzedakah Circle - $15000
Tzedakah Circle - $10000
Tzedakah Circle - $5000
Sustaining Membership (Prorated for Jan 1) - $2025
New Family who is also enrolling in Youth Education Grades K-2 - $0
Future Preschool Family Starting August 2025 - $1,000
Couple Newly Married by PTS Clergy - $0
Out of Town Membership
Other - I will contact PTS to discuss my commitment level
Annual membership commitment will be pro-rated quarterly for members who join after January 1.
We want to ensure that you remain a part of our congregational family. If you find yourself in a position where temple membership fees pose a challenge, please call Chief Community Officer Karen Wisialowski (
cco@sholom.org
or 650-697-2266) or Director of Finance & Operations Julie Orton (
jorton@sholom.org
or 650-697-2266), in confidence, to discuss special arrangements.
Please upload a family photo to share with the Board of Trustees.
Your photo will only be used for this single purpose.
New families choosing the Youth Education option above are required to pay the Facilities Assessment below.
For New Preschool families joining between January and June the Facilities Assessment will be billed in year 2.
Newly married couples will not be required to pay the Facilities assessment until year 2.
Tzedakah Circle members will be acknowledged and invited to a special event in their honor.
*
In addition to membership commitment, a Facility Reserve Assessment of $300 per year (for first 10 years of membership) is payable today today and on July 1 of the next nine years.
Please Select One
$300 Facility Reserve Assessment
I cannot make this payment today. I will contact PTS to discuss my situation
I am a Newly Married Couple or New Preschool family and will begin making this payment in year 2
I am joining as an out of town member
*
The Fine Print. Please check each box below.
Membership commitment and facilities reserve assessment are payable in full at the time of this application, and are invoiced on July 1 each year thereafter. Please let us know if you need to make alternative arrangements.
Due to advance planning and budgeting, membership commitment is not refundable.
Members must remain in good standing to be eligible for member services, including High Holy Day name badges, youth education, preschool at the member rate, and maintenance of b'nai mitzvah dates.
By completing this application, I/we agree to abide by the Bylaws and other regulations of the Temple.
We are thrilled that you are joining our PTS Community! After you click submit, you will hear from a member of the PTS staff to welcome you and answer any of your questions. Meantime, please feel free to reach out directly to Karen Wisialowski, Chief Community Officer, at
cco@sholom.org
.
Total Membership Commitment and Facility Reserve $
Fri, February 7 2025 9 Sh'vat 5785