Bdhls

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Family Membership Categories

Diamond	$2,400	Includes 5 HH seats
Platinum	$2,400	Includes 4 HH Seats
Silver	$900	Includes 2 HH Seats

Single Parents, Students
	$480	Includes 2 HH seats

New Membership Application Form
Congregant Information		Spouse Information
	Please select one:
Please select one:		Please select one:


Name :		Name :
Address :		Address :
Herbew Name :		Herbew Name :
Birth Date :		Birth Date :
Home Phone :		Home Phone :
Office Phone :		Office Phone :
Cell Phone :		Cell Phone :
E-Mail :		E-Mail :
Anniversary Date :		Anniversary Date :
Bar Mitzvah Portion :		Bar Mitzvah Portion :
Bar mitzvah Date :		Bar mitzvah Date :



Children Information


Child’s Name	Hebrew Name	Birthday	Bar Mitzvah Portion







Yahrtzeit


Hebrew Names	Day/Month/Year	Time of Passing	Relationship






Professional & General Information


Occupations and Company Name
Your Text Here


Other Congregational Affiliation
Your Text Here


2600 NE 209 St. Aventura, Fl 33180. Phone (305) 935 4140, Fax (305) 935 4155 E-Mail shul@bdhls.org

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