New Member Application - Form

At Temple Bat Yahm, membership is something special. It is a gateway to a community of support, prayer, kindness, and love. It gives families the ability to preserve memories of the past while creating memories for our future, all while ensuring the next generation has the tools to create a Jewish future filled with traditions of the past and hope for the future.

The information below will be the data we use for all aspects of your membership and your TBY Member Portal Profile. Please check the data carefully before you submit the form.

If you have questions about your membership benefits or profile, please email membership@tby.org or call the TBY Office at (949) 644-1999.

If you have questions about the billing for your membership, please reply to this email or call the TBY Office at (949) 644-1999 and ask to speak with Lesa Hodgkins, Accounts Receivable.

As we enter our 50th Anniversary, there are many ways to celebrate and we encourage you to join us. Your engagement has enriched and strengthened our congregational family and we look to honor that this year.

You can find this and more at our website at www.tby.org.

Primary Member: Member A Contact Information

* Member A First Name

Member A Middle Name

* Member A Last Name

Member A Preferred Name

If different from First Name

* Member A Email

* Member A Mobile

If you do not have a mobile phone number, please put the number you can best be reached at.

Primary Address

Where you would like mail sent to

City

* State

Zip

* Member A Birthday

Member A Gender

Member A Title/Honorific

Member A Profession/Occupation

Member A Professional Speciality

If applicable

Member A Employer/Business Name

Please Exclude my Profession in the Member Directory

* Member A Religious/Spiritual Affiliation

Member A Hebrew Name

Member A Father's Hebrew Name

Member A Mother's Hebrew Name

If Other, please specify

Relationship Status

Wedding Anniversary

Is there a Secondary Adult Member to Add to Your Membership?

Secondary Member: Member B Contact Information

Member B First Name

Member B Middle Name

Member B Last Name

Member B Preferred Name

If different from First Name

Member B Email

Member B Mobile

If you do not have a mobile phone number, please put the number you can best be reached at.

Member B Birthday

Member B Gender

Member B Title/Honorific

Member B Profession/Occupation

Member B Professional Speciality

If applicable

Member B Employer/Business Name

If applicable

Please Exclude my Profession in the Member Directory

Member B Religious/Spiritual Affiliation

Member B Hebrew Name

Member B Father's Hebrew Name

Member B Mother's Hebrew Name

Children & Dependents

Do you have any Children/Dependents under the age of 26 to include in your Membership

Children/Dependents under the age of 26 are included in their parent/guardians' membership

How many Children/Dependents do you have to enter?

First Name

Last Name

Birthdate

Please do not publish my child/guardian's likeness in any Marketing/Promotional materials

Email (if applicable)

Mobile Number (if applicable)

Current Grade

Name of Current School

I am interested in or would like to enroll in:

TBY PreschoolJewish Center of Arts & Learning (JCAL Religious School)B'nai Mitzvah ProgramTBY Youth Programming (Grades K-7)Tov B'Yachad BBYO Chapter (Grades 8-12)

If your child/children have already become B'nai Mitzvah, please provide their name(s) with the date(s) and location(s) of their Service(s):

Do you have any Adult Children over the age of 27 to list on your Profile

Adult Children over the age of 27 must have their own Membership

How many Adult Children do you have to list?

First Name

Last Name

Email (if applicable)

Mobile Number (if applicable)

Birthdate

Is this Adult Child a Current Member of TBY?

Yahrzeit Observance

Temple Bat Yahm observes Yahrzeits of loved ones during our 6:00 pm Friday Evening Shabbat Service.

Do you have any Yahrzeit to observe?

How many Yahrzeit do you have to observe?

Name of Deceased

English Date of Death

Our system will automatically calculate the Hebrew Date

Before or After Sunset

This will help us calculate the Hebrew Date

Would you like to observe this Yahrzeit on the English Date or Hebrew Date

Name of Mourner

Relationship to Mourner

Your Financial Commitment to Membership at Temple Bat Yahm

Membership Registration Date

Membership Registration after December 31st is prorated.
For questions, email membership@tby.org.

Please Select Your Change in Commitment

Circle of Honor - Platinum ($18,000)Circle of Honor - Gold ($10,800)Circle of Honor ($6,500)Simcha - In honor of our 50th Anniversary ($5,000)Mitzvah ($3,900)Sustaining ($3,300)I have had a confidential conversation about my Dues commitment, Security, or FMRI would like to have a confidential conversation about my Dues commitment, Security, or FMR

Membership at Temple Bat Yahm is designed for you to find a place in our congregational family with a commitment that is comfortable for your family.

There are many benefits to membership and each level has a unique opportunity. To see them all CLICK HERE.

I understand my financial commitment the Security Fee & Facility Maintenance Reserve

Security: In order to ensure the continued safety of our congregants, students, and campus, TBY requires an annual security fee of $575 per member unit.

Facility Maintenance Reserve (FMR): As part of your membership requirement, each family is assessed a total of $1800, beginning your second year of membership, payable over a six-year period at the rate of $300 per year. These funds are used to cover all facility maintenance costs for our Campus. This assessment is mandatory and must be paid to be considered a "member in good standing."

Your Payment Schedule & Method

* I would like my Commitment Payment Plan to Be:

Please Select OneOne Time Payment (July 1st)Bi-Annually (July 1st & December 1st)Quarterly (July 1st, October 1st, December 1st, & April 1st)Monthly (10 Payments Between July 1st & April 1st - Must be on Automatic Billing)

* How would you like to make your Financial Membership Commitemnt?

Please Select OneCredit Card - Automatic Billing Payment OptioneCheck - Automatic Billing Payment Option (Direct Payment from your Bank Account - ACH)Check - PersonalCheck - Donor Advised Charitable FundCheck - FoundationWire/Stock TransferCash

Type of Credit Card

Name on Card

Credit Card Number

Expiration Date

CVV

Name of Donor Advised Charitable Fund and Financial Institution

Name of Foundation