MAIN APPLICANT Name:* Title First Name Last Name Hebrew Name/s Hebrew Name Father's Hebrew Name Mother's Hebrew Name Date of Birth* 12345678910111213141516171819202122232425262728293031 Day1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Time* before sunsetafter sunset Mobile Number* E-mail* SPOUSE DETAILSIf applicable Name Title First Name Last Name Hebrew Name/s Hebrew Name Father's Hebrew Name Mother's Hebrew Name Date of Birth 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Time before sunsetafter sunset Mobile Number E-mail In order to simplify the application process, this form does not include details of lifecycles and/or children. We will send you a follow-up form for these details. PAYMENT & CONFIRMATION I hereby accept membership to Congregation Beit Menachem and look forward to participating in the various activities and events organized by the Congregation. Membership 2026-27 Fees Seat Rental Security Levy Annual Monthly Family (Includes 2 High Holidays reserved-named seats, and the benefits listed above) $20 $2330 $200 $2,550 $215.50 Single (Includes 1 High Holidays reserved-named seat, and the benefits listed above) $20 $1340 $200 $1,560 $130 Payment Options 2026-27* Family (Annual)Family (Monthly)Single (Annual)Single (Monthly) Total $0.00 AUD Payment* Credit Card Direct Debit Credit Card We accept Visa, MasterCard, American Express Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearPlease fill-in your BSB and Account Number in the notes section below. Notes/Comments: Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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This page uses TLS encryption to keep your data secure.
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