Membership Application

Note: Please complete each tab and click the submit button on step 3 to complete.

A full copy of this form will be emailed to you for your records after you hit the submit button on tab 3.
You may choose to print each page singly with print button on bottom of each tab.
All information provided is private and will not be shared with anyone without your written permission.

Step 1

General Info

Member Info
Name *
Please type your full name.
Home Address *
Invalid Input
City *
Invalid Input
State *
Invalid Input
Zip Code *
Invalid Input
Home Phone *
Invalid Input
Billing Info
Is billing address the same: *
Invalid Input
If no, write billing address
Phone
Marital Status
Anniversary Date
Invalid Input
Print

Step 2

Member Information

Adult 1
Full Name *
Invalid Input
Date of Birth
Occupation/Profession
E-Mail Address
Cellular Phone
Home Fax Number
Business Name
Business Address
Business City, State, Zip
Business Phone & ext. no.
Religious Tradition in which you were raised.
List relationship to any member of our congregation.
Referred by

Child 1
First Name
Birthdate
If student, name of school public/private/current grade
E-Mail Address

Child 3
First Name
Birthdate
If student, name of school public/private/current grade
E-Mail Address
Adult 2
Full Name
Date of Birth
Occupation/Profession
E-Mail Address
Cellular Phone
Home Fax Number
Business Name
Business Address
Business City, State, Zip
Business Phone & ext. no.
Religious Tradition in which you were raised.
List relationship to any member of our congregation.
Referred by

Child 2
First Name
Birthdate
If student, name of school public/private/current grade
E-Mail Address

Child 4
First Name
Birthdate
If student, name of school public/private/current grade
E-Mail Address
Print

Step 3

Yahrzeit

Please list names and dates of those for whom you wish Yahrzeit (anniversary of death) notices sent.

Yahrzeit Family Member
Name
Yahrzeit Date
Before or After Sundown
Relationship to Which Member

Yahrzeit Family Member
Name
Yahrzeit Date
Before or After Sundown
Relationship to Which Member

Yahrzeit Family Member
Name
Yahrzeit Date
Before or After Sundown
Relationship to Which Member
Yahrzeit Family Member
Name
Yahrzeit Date
Before or After Sundown
Relationship to Which Member

Yahrzeit Family Member
Name
Yahrzeit Date
Before or After Sundown
Relationship to Which Member

Yahrzeit Family Member
Name
Yahrzeit Date
Before or After Sundown
Relationship to Which Member

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Shomrei Torah Synagogue
7353 Valley Circle Boulevard
West Hills, CA 91304
 
Main Office: (818) 854-7650
Education Center: (818) 854-7690

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Shabbat @ STS

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DAILY MINYAN
Monday - Friday: 8:00am
Monday - Thursday:  7:30pm
Sunday and legal holidays: 9:00am
All services in Heytow Chapel.
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