MEMBERSHIP INFORMATION | Application Form

Instructions

Please submit your membership application form below. Then complete the annual dues pledge.

Note: You may also print this form and mail to Hevrat Shalom Congregation, P.O. Box 3606, Gaithersburg, MD 20878.

Membership Application Form

Personal Information

Children

Include all unmarried children living with you, another parent or away at school.
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Yahrzeits Observed (English Date)

Additional Information

Please indicate areas you might be interested in participating in or learning more about.

Signature

By affixing my/our signature(s) to this application, I/we hereby agree to abide by the Constitution and By-Laws of the congregation, and to maintain my/our membership in good standing.
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