The Sholem Community - Registration

2010 - 2011 Registration
for renewals and new memberships in our
Sholem Community and Sunday School

formRegistration has two steps:

form(2) Click here to pay 2010 - 2011 membership fees
Note: This online form replaces registration form that was mailed in years past.

Registration Form
Member # 1 Information		Member # 2 Information
First Last Name :		First Last Name :
Email:		Email:
Address :		Address :
City : State : Zip :		City : State : Zip :
Telephone: (home)		Telephone: (home)
Telephone: (work)		Telephone: (work)
Telephone: (cell)		Telephone: (cell)
Occupation:		Occupation:
Committee Choice - Member # 1 To choose more than one committee: CTL-Click for Windows or Command-Click for Mac		Committee Choice - Member # 2 (To choose more than one committee CTL-Click for Windows or Command):
I am willing to be a classroom parent: yes no		I would like to be a classroom parent: yes no
Student Information
Last Name:	First Name:	School Grade:	Date of Birth:
Last Name:	First Name:	School Grade:	Date of Birth:
Last Name:	First Name:	School Grade:	Date of Birth:
In case of emergency, list one alternate contact
Name: catPhone:
Print this page before submitting registration Upon submitting your registration, you will be taken to our payment options page

In case of emergency, list one alternate contact