Membership Form - Form - Hebrew Educational Alliance

Please help us get to know your family. How many adults will be on this Membership account?

* First Name

* Last Name

Nick Name

* Date of Birth

* Mobile Number

* Email Address

Gender

* Adult 1 Hebrew Name

* Jewish by:

Date of Conversion

Rabbi who performed Conversion

Location of Conversion

* Occupation

* Current Employer

Work Phone

Do you have any physical restrictions or special needs?

Please click the + button to add each yahrzeit to this Member.

Deceased Name

Relationship to Adult 1

English Date of Death

Before/After Sunset

Place of Burial

* Frist Name

* Last Name

Nick Name

* Date of Birth

Phone Number

Email Address

Gender

* Adult 2 Hebrew Name

* Jewish by...

Date of Conversion

Rabbi who performed the conversion

Location of the conversion

Occupation

Current Employer

Work Phone

Do you have any physical restrictions or special needs?

Please click the + button to add each yahrzeit to this Member.

Deceased Name

Relationship to Adult 1

English Date of Death

Before/After Sunset

Place of Burial

* Marital Status

Date of Marriage

Emergency Contact (Not living with you)

Emergency Contact Phone Number

Emergency Contact Relationship

How would you like your mail addressed to you?

Address

City

State

ZIP CODE

Home Phone

How did you hear about Hebrew Educational Alliance?

How many children through college will be on this Membership account?

* English Name

Hebrew Name

* Date of Birth

* Place of Birth

* English Name

Hebrew Name

* Date of Birth

* Place of Birth

* English Name

Hebrew Name

* Date of Birth

* Place of Birth

* English Name

Hebrew Name

* Date of Birth

* Place of Birth

This form is for NEW members only. If you are joining at the Plus Membership rate, please contact Amy Karp, Director of Engagement at 303-758-9400, ext. 214. If you are a current member wishing to pay your dues, please log into your account or call the office for assistance, 303-758-9400. Thank you!

The amount you will be billed is based on the month after joining through April 2024. For example, if you join in December, your bill for the year will be computed from January through April.

If you have financial concerns or questions or if you are planning on joining at the Plus Member level, please contact our Amy Karp, Director of Engagement at 303-758-9400, ext. 214. We welcome your membership in the Congregation Hebrew Educational Alliance.

Please contact Amy Karp, Director of Engagement to arrange the pro-rated payment for new member dues by calling 303-758-9400, ext. 214.
Couple or Family
Single / Individual
Young Couple/Family (ages 21 - 36 and/or children enrolled in the HEA Preschool)
Young Single (ages 21 - 35)
Associate Member

Total Membership Fee