Thank you for your interest in learning more about Leo Baeck Temple.

We are proud of the active, caring and committed community that our temple offers its members. Leo Baeck Temple is a place where individuals and families discover the fulfillment of being in deep relationship with one another, and discover the unique embrace of our congregation. We hope that you will be a part of this exciting time—and an even more exciting future—at Leo Baeck.

Membership at LBT can offer you numerous blessings. You will have access to our clergy’s assistance at the times of greatest joy and greatest sorrow in your life. Depending on your stage of life, your family will be enabled to enroll in our creative, experiential Religious School, our outstanding B’nai Mitzvah and Confirmation programs, our intimate and innovative Tot Shabbat, Tiny Tot, and Pre-K offerings for our families with young children or our engrossing community of engagement. You will also have multiple opportunities to enjoy the great breadth of our congregation’s programs—everything from community organizing to Torah study, worship services to ‘Bubble up’ Groups, book reviews to arts experiences, our softball teams to our women’s and men’s groups. There are multiple ways for everyone to get involved here at Leo Baeck Temple, and most importantly, they all foster a deep sense of connection between our members. LBT is a place that you will be proud to call home … a place where the people you meet will make you feel at home. We hope you will add to the warmth of our community by joining us!

If you have any questions regarding the following material or Temple programs, please feel free to contact me at aspiegel@leobaecktemple.org or 310.476.2861 ext 204. I look forward to meeting you and I hope you will consider becoming a part of our congregation.

Warmest Regards,

Abigail Goldberg Spiegel
Executive Director

If you have any questions about how to complete this form, please contact Drew Davis at ddavis@leobaecktemple.org or 310.476.2861 ext 202.

Household Information

Home Address

City

State

Zip Code

Home Phone

Marital Status

Anniversary Date

Personal Information

Member 1

Member 2

Last Name

First Name

Gender - I identify as:

Date of Birth (m/d/y)

Mobile Phone

Email Address

Occupation/Title

Employer

Work Address

Work Telephone

Work Email

Work Telephone

Work Email

Member 1 Retired?

YesNo

Member 2 Retired?

YesNo

If Retired, Former Occupation

Religious Upbringing:

Hebrew names can be entered using English transliteration or in Hebrew using the Hebrew keyboard. (Click on icon at right of each field.)

Hebrew Name

Father's Hebrew Name

Mother's Hebrew Name

Father's Hebrew Name

Mother's Hebrew Name

Medical/Emergency Information

Other (please specify)

Are you a blood donor?

YesNo

Are you a blood donor?

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If yes, indicate blood type

In case of emergency, the Temple should notify:

Relationship

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FAMILY INFORMATION

Children in your home 25 years old and under

CHILD 1

CHILD 2

CHILD 3

CHILD 4

First Name 1

First Name

Last Name

Hebrew Name

Identifies as:

Date of Birth

Make

Name of School/College

Grade/Year

So that we may better accommodate your child's needs, please indicate any physical limitations:

VEHICLE INFORMATION

Vehicle #1

Vehicle #2

Vehicle #3

Vehicle #4

Make

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YAHRZEIT INFORMATION

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*Simply give us the Gregorian (secular) month, date, and year, and we will convert it to the Hebrew date (Ex: June 30, 2000).

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Observed by (member's name)

Relationship

Yahrzeit Date

Full English Name

Observed by (member's name)

Relationship

Yahrzeit Date

Full English Name

Observed by (member's name)

Relationship

Yahrzeit Date

Full English Name

Observed by (member's name)

Relationship

Yahrzeit Date

Full English Name

Observed by (member's name)

Relationship

Yahrzeit Date

Full English Name

Observed by (member's name)

Relationship

Yahrzeit Date

INTERESTS

Involvement in Temple life will enhance your experience at Leo Baeck Temple. Please indicate your interest by checking any and all of the following areas:

COMMUNITY COMMITMENT

Sustaining Tzedek at LBT

The Talmud teaches “Kol Yisrael arevim zeh b’zeh” – “all Jews are responsible for one another.” In keeping with that value, Leo Baeck Temple has long embraced the conviction that members who are financially able should be counted upon to help those of our members who are less able to afford membership. Sustaining Tzedek at LBT maintains our egalitarian community, where no one is denied the opportunities of temple membership because of monetary difficulties. Please consider joining this group willing to fulfill the mitzvah of tzedakah by pledging an amount in addition to your standard membership commitment.

I/We would like to fulfill the mizvah of tzedakah by pledging the following amount, in addition to our standard membership contribution:

Suggested donation levels: $18,000, $13,000, $10,000, $5,000, $3,500, $1,500, $720, $360 (enter amount)

ARZA Membership
ARZA: the mission of ARZA is to further progressive Judaism in Israel. The Temple encourages all members to join ARZA.

Dues are $50 per year (enter amount, if applicable)

ARZA Membership

Total

Please charge all fees to my preferred payment method until further notice.

Community Commitment Form 2023-24

Household Information

Personal Information

Medical/Emergency Information

FAMILY INFORMATION

VEHICLE INFORMATION

YAHRZEIT INFORMATION

INTERESTS

COMMUNITY COMMITMENT

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