Congregation Kol Ami A Conservative Congregation Affiliated with the United Synagogue of Conservative Judaism 3919 Moran Road, Tampa, Florida 33618 813-962-6338 B’ruchim Habaim: Welcome to Congregation Kol Ami MEMBERSHIP INFORMATION FORM We are delighted that you are interested in Congregation Kol Ami. Please take a moment to get to know us by reviewing the information contained in this membership packet. It is our hope that new members will feel welcomed, at home, and a part of our congregational family. If there is anything on this form that you have questions about or are not sure how to answer, just let us know and/or fill it out the best you can. Thank you for taking the time to give us your information. Would you prefer to print the application out and bring it into Congregation Kol Ami? Click on the links below to open up the different documents. Membership Application Yahrzeit Observance Form Kol Ami Picture Release Form Dues Structure Chart Dues Commitment Form Credit Card Authorization Form Date Prepared How Did You Hear About Us? Name(s) of Adult(s) * Address * City * State * Zip * Email Address * Best Phone Number To Reach You At * Adult #1 Full Name Title - None -Mr.Ms.Mrs.Dr.Other Full Name * Hebrew Name Gender * - Select -MaleFemale Date Of Birth month/date/year * Email Address * Occupation/Profession Employer and/or Business Business Phone Cell Phone * Current Marital Status * - Select -SingleMarriedDivorcedSeperated If married month/date/year Adult #2 Full Name Title - None -Mr.Ms.Mrs.Dr.Other Full Name Hebrew Name Gender - None -MaleFemale Date Of Birth month/date/year Email Address Occupation/Profession Employer and/or Business Business Phone Cell Phone Current Marital Status - None -SingleMarriedDivorcedSeperated If married month/date/year
