Shalom Haverim, Thank you for your interest in Temple Beth

Shalom Haverim,
Thank you for your interest in Temple Beth Haverim. As we continue to celebrate our
25th anniversary in the community, our synagogue continues to be a “house of friends, a
house of gathering, a house of study, and a house of prayer.” We celebrate the values
of family and friendship.
TBH is a conservative congregation under the spiritual guidance of Rabbi Gershon
Weissman and Cantor Kenny Ellis. Together, they provide a warm, friendly, dynamic
and caring community for all to worship, celebrate and to promote the values of Jewish
life. Our community represents a diverse, inclusive, participatory family where all are
welcomed with warmth and respect.
We offer an award-winning two day a week accredited Hebrew school and provide the
foundation for the development of a knowledgeable student who has a strong sense of
commitment to the Jewish people, religion, values, heritage, and traditions. Our Early
Childhood Center provides a safe and nurturing Jewish environment in which young
children can grow cognitively, socially, emotionally, creatively, and spiritually.
We also offer exciting youth and senior programming, free adult education classes,
Havurot, engaging guest speakers, inspirational Shabbat services, and a variety of
activities, events, and educational programming.
Here are a couple of our amazing speakers in May & June: Zev Yaraslovsky,
Tsafi Reuven~ Israeli Hero in the Entebbe Operation to free HostagesShabbat Yiddish Sing-A –Long Service, Rededication of our two Torah Scrolls
Shabbat Under the Stars and Shavuot Service followed by a wonderful dinner.
This year we are pleased to announce that we are continuing to offer Tuition-Free
Hebrew School to children in grades K-2 (book & material fees will apply)
Come join our “House of Friends” and become a part of our growing and active
congregation in the Conejo Valley.
We would love for your family to be a part of our family.
If you have any questions please call our Membership Vice Presidents- Dena Feingold
or Stacey Held or Temple Administrator Eva Gladstone at 818-991-7111.
We look forward to meeting you soon!
B’Shalom,
Dena Feingold
VP Membership
Stacey Held
VP Membership
New Member
2009/2010
Membership Interest
Please place a check next to the groups you wish to join. We will contact you soon.
_____Sisterhood—FREE FOR FIRST YEAR
Women are the keepers of the flames of mitzvot, family, study, Israel, Torah and community. We band together in friendship
for programs to benefit the Temple and community, for social activities, for study, and above all, for the growth of the
individual so that each may find an opportunity to fulfill her potential as a person and as a Jewish woman while having fun.
We are affiliated with the Women’s League of Conservative Judaism. Cost to join is $36 per year.
_____Men’s Club— FREE FOR FIRST YEAR
Our men’s club is a vital part of our community and active in all aspects of Temple life. We sponsor programs throughout the
year that promote fellowship, fun, and tzedakah. We are dedicated to providing our members growth in religious, personal,
and professional aspects of their lives. We are affiliated with the Federation of Jewish Men’s Clubs. Cost to join is $36 per year.
_____Choirs
Music is an important part of how we worship at TBH. We offer adult and children’s choirs under the direction of Cantor
Kenny Ellis and Eileen Weiser. All you need is a love for music and a desire to be part of a group that makes music in a Jewish way.
Your singing will help create a prayerful atmosphere at our Temple.
_____Havurah
The root of the word Havurah is the same as the root for friend. A Havurah is a group of Temple Beth Haverim families who meet
to share Jewish learning experiences in an “extended family” setting. Each Havurah creates their own journey to offer its members
yet another way to grow Jewishly, as adults through education and discussion, as families, through celebration of Jewish holidays,
and as friends, gathering to enjoy one another on a social level. Our co-ordinator, who along with the Rabbi and Cantor, will work
with each group to help inspire innovative programming. New Havurah groups are always forming.
_____Young Seniors
For those who think young. Our young seniors are a dynamic group who lend their expertise to the Temple and in the process
have a good time. Programs consist of lectures, luncheons, films, trips and social events. Cost to join is $18 per person per year.
Name: _____________________________________________ Name: ______________________________________________ E-Mail Address:______________________________________
E-Mail Address:_______________________________________ Phone:_____________________________________________
Phone:______________________________________________ 29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Volunteer Interest
“It is a mitzvah to be involved”
Temple Beth Haverim has many different opportunities for members to become
involved in the planning and operation of our temple and we need your help.
Below is a list of some of the volunteer opportunities.
Please check your areas of interest and you will be contacted soon.
Name: _______________________________________________________________________________________________
(
)
Home Phone: _________________________________
E-mail: _________________________________________________
___ Administration – Temple office
___ Communications/Public Relations
___ Scrip Program
___ A
dvertising/Press Releases/Newsletter
___ Phone Tree
___ Website
___ Religious School Office
___ Adult Education
___ Assist In Religious School Classroom
___ Israel Action Committee
___ Assist In Pre School Classroom
___ Facilities
___ Finance
___ Capital Campaign
___ Membership
___ Strategic Planning
___ Havurot
___ Social Action
___ Women’s Programming
___ Youth Committee
___ Religious Practices/Special Services
___ High Holy Days/Ushering
___ B
ikur Cholim Services
(visiting the sick)
___ Shabbat Service Ushering
___ Bereavement Support
___ Torah Chanting
___ Passover Seder
___ Fundraising
___ Purim Carnival
___ Cantor’s Concert
___ Drive to Doctor’s Appointments, etc.
___ Menorah Lighting at the Promenade
___ Volunteer Committee
___ Dinner Dance Committee
___ Other – Here’s What I Can Offer : _ _____________________________________________________
______________________________________________________________________________________
Please call Eva Gladstone, Temple Administrator, at (818) 991-7111
or send an e-mail to [email protected] should you have any questions.
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Refer a Friend
Temple Beth Haverim is pleased to offer a program that will reward you each time you
refer a friend who joins our wonderful synagogue.
Here’s how it works:
You will receive a $100 credit for every full-dues paying new member or returning
member (family who has been gone for at least one year) who joins the temple.
Your billing statement will reflect the credit or if you prefer not to receive the $100 credit,
we will gladly send you a donation letter.
You can refer as many families as you choose, there is no limit.
Your name will be prominently listed in our monthly newsletter every time you refer a friend.
Please complete the information below.
Your name: ____________________________________ (
)
Phone: ______________________________________
Name of family you referred: ____________________________________________________________________
_____Please credit my account $100 for every family referred.
Your account will be credited once registration is completed by the new family.
OR
_____Please do not credit my account but send me a donation letter.
Signature: ______________________________________________________ Date: ________________________
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Schedule Of Classes Grades 3 through 10
Dear Parents:
Beth Haverim means “House of Friends.” It is a place where, together, we teach our children the best
that Judaism has to offer. Our Hebrew School features proven, innovative approaches to Jewish
education in an engaging, relevant, and challenging manner. Our educational goals focus on
individual students needs and interests, adding enrichment in art, music, and family-centric activities.
We provide an environment immersed in the celebration of Jewish life, encouraging the observance of
the holidays and Shabbat, while living ethically and morally in today’s world.
• 3rd thru 6th grades will meet on Mondays and Wednesdays from 4:15-6:15 p.m. or Tuesdays from
4:15-6:15 p.m. and Sundays from 9:30-11:30 a.m.
• 7th grade will meet on Wednesdays from 6:30 – 8:00 p.m. and Mondays once per month with Rabbi.
• 8th thru 10th grade will meet every other Monday from 6:30-8:00 p.m.
Please return your completed membership and school registration forms
by Friday, May 29, 2009
We look forward to working with your children and your family.
Shalom,
Linda Shulman
Vice President of Education
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Grades 3 through 10 Hebrew School Registration
Please complete all information on both sides of this form in ink. Please note: a form must be completed for each child.
/
/
Date: ____________________
Student’s Last Name
First Name
Date of Birth
Student’s Hebrew Name
School District Enrolled in: ❑ Oak Park ❑ Las Virgenes
/
/
❑ Conejo Valley ❑ LAUSD ❑ Other (please specify) _____________________
Secular Grade in 2009-2010
Hebrew School Grade 2009-2010 (if different than Secular)
Bar/Bat Mitzvah Date (if scheduled)
Name of School:
New Student: Has child attended any other Religious School? ❑ Yes ❑ No Did child attend any other Preschool? ❑ Yes ❑ No
If so, which one(s)?
Temple Name ________________________________________ What grades? _______________ City _________________________________________________ State ______________________
Mother’s Last Name ❑ Step Parent
Occupation
Work Phone
(
Cellular Phone
(
First Name
Pager
)
(
)
Father’s Last Name ❑ Step Parent
First Name
Occupation
Work Phone
(
Cellular Phone
)
(
Does student reside with: ❑ Mother ❑ Father ❑ Step Parent ❑ Both Parents
Pager
)
(
)
)
Marital status of parent(s): ❑ Married ❑ Separated/Divorced ❑ Widowed
Primary Home Address ❑ Mother ❑ Father ❑ Step Parent
Primary Home Phone
(
City
)
State
Zip
Second Home Address ❑ Mother ❑ Father ❑ Step Parent
Second Home Number
(
City
)
State
Zip
Does student have sibling(s) who attend Temple Beth Haverim Religious School ❑ Yes ❑ No If yes, please list below.
1. Name of Sibling
Grade
2. Name of Sibling
Grade
3. Name of Sibling
Grade
Please check one:
❑ 3rd Grade
❑ 4th Grade
❑ 5th Grade
❑ 6th Grade
❑ 7th Grade
❑ 8th Grade
❑ 9th Grade
❑ 10th Grade
❑ Mon/Wed from
4:15-6:15 p.m. OR
❑ Mon/Wed from
4:15-6:15 p.m. OR
❑ Mon/Wed from
4:15-6:15 p.m. OR
❑ Mon/Wed from
4:15-6:15 p.m. OR
Every other Monday
6:30-8:00 p.m.
❑ Tues 4:15-6:15 p.m.
& Sun 9:30-11:30 a.m.
❑ Tues 4:15-6:15 p.m.
& Sun 9:30-11:30 a.m.
❑ Tues 4:15-6:15 p.m.
& Sun 9:30-11:30 a.m.
❑ Tues 4:15-6:15 p.m.
& Sun 9:30-11:30 a.m.
Every Wednesday
6:30-8:00 p.m. AND
Mondays once
a month with Rabbi
Every other Monday
6:30-8:00 p.m.
Every other Monday
6:30-8:00 p.m.
Please complete reverse side
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Emergency Form and Consent to Treatment of Minor
Please complete this entire form. It is imperative for your child’s safety.
/ /
Pupil_ ____________________________________________________ D.O.B. __________________ Grade Level_ ___________
Last Name
First Name
Mother’s Name_______________________ Father’s Name________________________
)
(
)
(
)
Home Phone__(____________________
Mother’s Cell _______________________
Father’s Cell _ ________________________
)
)
Mother’s Work __( _____________________
Father’s Work _(_______________________
Home Address_ _____________________________________________ City__________________________Zip______________
Doctor Name_ ____________________________________________________________ Doctor Phone (_____)______________________
Medical-Health Insurance Company____________________________________________ Policy Number____________________________
In case you are unable to reach me during any emergency, you are authorized to contact the following:
Name__________________________________________ Relation_ ______________________ Phone (______)________________________
Name__________________________________________ Relation _______________________ Phone (______)________________________
Emergency Out-of-State Person __________________________________________________ Phone (______)_______________________
Your Child’s Allergies/ Dietary Restrictions______________________________________________________________________________
________________________________________________________________________________________________________________
Please note any special health problems (asthma, medication, etc.)_ _________________________________________________________
Will your child be on the medicine during Hebrew School? Yes
No
Please indicate any special services your child receives at his/her secular school_ ______________________________________________
________________________________________________________________________________________________________________
Please list any medical condition that may interfere with your child’s learning_________________________________________________
________________________________________________________________________________________________________________
Describe any family arrangements that might affect your student’s attendance________________________________________________
________________________________________________________________________________________________________________
I/We, the undersigned parent(s) of Minor _____________________________________________ do hereby consent to any X-ray examination, anesthetic, medical
or surgical or dental diagnosis of treatment and hospital service that may be rendered to said minor under the general or special treatment and hospital service
that may be rendered to said minor under the general or special instructions of our physician or dentist or other physician or dentist called in any emergency by the
Principal, the Rabbi, or responsible adult in the event I/We can not be reached; whether such diagnosis is rendered at the office of said physician or licensed hospital.
It is understood that conscientious effort will be made to notify me or my spouse before such action is taken; but if this is not possible, the expense of this service
will be accepted by me. It is understood this consent is given in advance of any specific diagnosis or treatment being required. This consent should remain effective
until revoked.
Please print name of parent
Signature of parent Date
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
Temple Beth Haverim
2009/2010
Grades Kindergarten through 2
Hebrew School Registration
Please complete all information on both sides of this form in ink. Please note: a form must be completed for each child.
/
/
Date: ____________________
Student’s Last Name
First Name
Date of Birth
Student’s Hebrew Name
School District Enrolled in: ❑ Oak Park ❑ Las Virgenes
/
/
❑ Conejo Valley ❑ LAUSD ❑ Other (please specify) _____________________
Secular Grade in 2009-2010
Hebrew School Grade 2009-2010 (if different than Secular)
Bar/Bat Mitzvah Date (if scheduled)
Name of School:
New Student: Has child attended any other Religious School? ❑ Yes ❑ No Did child attend any other Preschool? ❑ Yes ❑ No
If so, which one(s)?
Temple Name ________________________________________ What grades? _______________ City _________________________________________________ State ______________________
Mother’s Last Name ❑ Step Parent
Occupation
Work Phone
(
Cellular Phone
(
First Name
)
Pager
(
)
Father’s Last Name ❑ Step Parent
First Name
Occupation
Work Phone
(
Cellular Phone
)
(
Does student reside with: ❑ Mother ❑ Father ❑ Step Parent ❑ Both Parents
Pager
)
(
)
)
Marital status of parent(s): ❑ Married ❑ Separated/Divorced ❑ Widowed
Primary Home Address ❑ Mother ❑ Father ❑ Step Parent
Primary Home Phone
(
City
)
State
Zip
Second Home Address ❑ Mother ❑ Father ❑ Step Parent
Second Home Number
(
City
)
State
Zip
Does student have sibling(s) who attend Temple Beth Haverim Religious School ❑ Yes ❑ No If yes, please list below.
1. Name of Sibling
Grade
2. Name of Sibling
Grade
3. Name of Sibling
Grade
In order for your child/children to get the most out of
their Kindergarten – 2nd grade years – we need you to be
involved. Parent partners will be asked to come to class once
a quarter and to provide snack on that day. It will be a great
way for you to see what is going on and to demonstrate the
value of Hebrew School.
Please check one:
Grade
❑ Kindergarten
❑ 1st
❑ 2nd
Schedule
❑ Wed from
4:15- 6:15p.m. OR
❑ Sun from
9:30-11:30a.m.
❑ Wed from
4:15-6:15p.m. OR
❑ Sun from
9:30-11:30a.m.
❑ Wed. from
4:15-6:15 p.m. OR
❑ Sun from
9:30-11:30a.m.
Please indicate choice:
I can volunteer to be a parent partner in the classroom once a quarter _____________________yes
_____________________no
I am unable to commit to being a parent partner for my child’s class and therefore, I will commit to paying $160.00 for the entire year —
or $40.00 for each quarter I cannot participate as a parent partner. I will commit to ___________quarters.
Signed:_________________________________________ Date: ________________________
Please complete reverse side
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Emergency Form and Consent to Treatment of Minor
Please complete this entire form. It is imperative for your child’s safety.
/ /
Pupil_ ____________________________________________________ D.O.B. __________________ Grade Level_ ___________
Last Name
First Name
Mother’s Name_______________________ Father’s Name________________________
)
(
)
(
)
Home Phone__(____________________
Mother’s Cell _______________________
Father’s Cell _ ________________________
)
)
Mother’s Work __( _____________________
Father’s Work _(_______________________
Home Address_ _____________________________________________ City__________________________Zip______________
Doctor Name_ ____________________________________________________________ Doctor Phone (_____)______________________
Medical-Health Insurance Company____________________________________________ Policy Number____________________________
In case you are unable to reach me during any emergency, you are authorized to contact the following:
Name__________________________________________ Relation_ ______________________ Phone (______)________________________
Name__________________________________________ Relation _______________________ Phone (______)________________________
Emergency Out-of-State Person __________________________________________________ Phone (______)_______________________
Your Child’s Allergies/ Dietary Restrictions______________________________________________________________________________
________________________________________________________________________________________________________________
Please note any special health problems (asthma, medication, etc.)_ _________________________________________________________
Will your child be on the medicine during Hebrew School? Yes
No
Please indicate any special services your child receives at his/her secular school_ ______________________________________________
________________________________________________________________________________________________________________
Please list any medical condition that may interfere with your child’s learning_________________________________________________
________________________________________________________________________________________________________________
Describe any family arrangements that might affect your student’s attendance________________________________________________
________________________________________________________________________________________________________________
I/We, the undersigned parent(s) of Minor _____________________________________________ do hereby consent to any X-ray examination, anesthetic, medical
or surgical or dental diagnosis of treatment and hospital service that may be rendered to said minor under the general or special treatment and hospital service
that may be rendered to said minor under the general or special instructions of our physician or dentist or other physician or dentist called in any emergency by the
Principal, the Rabbi, or responsible adult in the event I/We can not be reached; whether such diagnosis is rendered at the office of said physician or licensed hospital.
It is understood that conscientious effort will be made to notify me or my spouse before such action is taken; but if this is not possible, the expense of this service
will be accepted by me. It is understood this consent is given in advance of any specific diagnosis or treatment being required. This consent should remain effective
until revoked.
Please print name of parent
Signature of parent Date
PLEASE BE SURE THAT YOU HAVE FILLED OUT ALL THE REQUIRED INFORMATION ON BOTH SIDES.
ANYTHING OMITTED WILL HINDER YOUR CHILD’S EARLY REGISTRATION
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Youth Department
USY/KADIMA
Registration
TBH/USY Stands for “Temple Beth Haverim United Synagogue Youth”.
USY is the official youth group of the Conservative Movement.
TBH/USY consists of four groups:
n
n
n
KADIMA, for children in the 4th-6th grades
JUNIOR USY, for teenagers in the 7th-8th grades
SENIOR USY, for teenagers in the 9th-12th grades
USY is:
n
n
An international organization with a membership of more than 25,000 young people
across the United States and Canada, divided into 17 regions
Part of Far West Region, with a membership of more than 1,800 Jewish Teens
in Southern California, Nevada, New Mexico, Utah, and Hawaii
Joining USY and Kadima entitles members to:
n
n
n
Attend all chapter (Temple) activities at member rate
Attend regional and international events such as Kinnusim (weekends), USY dances,
conventions, and much more
Be part of a Jewish youth group, even if they are not Temple members
After you fill out the membership information on the other side, you will receive a calendar of
events for the upcoming year, and other paperwork so that you can participate in our amazing
fun-filled activities. Come find out what it really means to be a leader, have fun, and be Jewish!
All is waiting for you in USY!! Sign-up today!
Annual Dues
TBH Families
Kadima (4th – 6th Grade)$65.00
United Synagogue Youth (7th – 12th Grade)$80.00
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Children:
United Synagogue Youth & Kadima
Membership Registration
)
1) Name _______________________________________________________________ Phone _(______________________________
E-Mail (very important) _ ________________________________________________ School_ ______________________________
Grade ___________ Birthdate ___________/ ___________/ ___________
(
)
2) Name _______________________________________________________________ Phone _______________________________
E-Mail (very important) _ ________________________________________________ School_ ______________________________
Grade ___________ Birthdate ___________/ ___________/ ___________
(
)
3) Name _______________________________________________________________ Phone _______________________________
E-Mail (very important) _ ________________________________________________ School _______________________________
Grade ___________ Birthdate ___________/ ___________/ ___________
)
Mother’s Name _ ________________________________________________________ Work Phone _ (_________________________
)
Father’s Name___________________________________________________________ Work Phone _ (_________________________
Home Address_ ______________________________________________________________________________________________
City_ _________________________________________ ZIP _ _____________________ E-Mail (very important) _ ________________
Code Of Conduct:
 There will be proper conduct at all times. Treat people with respect; be a positive leader and a good example.
 No one may leave the program at any time without proper permission by the youth director or designee, and
written permission of the parent or guardian.
 Possession or use of drugs or alcohol will not be tolerated. Any youth possessing or suspected of being
under the influence of drugs or alcohol will be removed from the program at his/her family’s expense.
 All events sponsored by the tbh youth department will adhere strictly to the laws of Kashrut and Shabbat.
1) Signed (member) _ ______________________________________________ Signed (parent) ______________________________
2) Signed (member) _ ______________________________________________
3) Signed (member) _ ______________________________________________
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
FAMILY RECORD
Family Name:_ ___________________________________________________________________________________________
(Please print name as you wish to be listed on the Synagogue Roster
(
)
Home Address:______________________________________________ Home Phone _ ________________________________
City:_______________________________________________________ State:_ ________________ Zip_____________________
Mailing Address:__________________________________________________________________________________________
(
)
Cell No.:____________________________________________
Email:_________________________ Email:_ _________________
Marital Status:
❑ Single
❑ Married
❑ Divorced
Anniversary date: _______________
Adult Male
Adult Female
❑ Reform ❑ Conservative ❑ Orthodox
❑ Reconstructionist ❑ Non-practicing
❑ Non Jewish (if so, did you convert to Judaism)
❑ Yes, date of conversion________ ❑ No
❑ Reform ❑ Conservative ❑ Orthodox
❑ Reconstructionist ❑ Non-practicing
❑ Non Jewish (if so, did you convert to Judaism)
❑ Yes, date of conversion________ ❑ No
Full Name (Dr., Mr., Mrs., Ms., etc.)
Date of Birth
Blood Type
Occupation or Profession
Business Name/Type of Business
Business Address
Business Phone
Business FAX #
Religious tradition in which
you were raised
Hebrew Name
List relationship to any member of
Temple Beth Haverim
Areas of Jewish expertise
(read Torah, chant Haftorah, etc.)
Other Jewish organization affiliation
(Adequate information about each member will enable us to provide activities, which better meet the needs of our members.
Your religious backgrounds are requests for statistical purposes and will be held in the strictest confidence.)
Please See Reverse Side.
New Member
2009/2010
Children
Please fill in the following information as it applies to each of your children.
First Name
Middle Name
Surname (if different)
Hebrew Name
Birth Date
Male / Female
If student, grade of school
If preschool, name of school
Biological or adopted
Date of Bar/Bat Mitzvah
Marital Status
Name of his/her
Spouse (if married)
(Please attach additional sheet with identical information for additional children)
Yahrzeit Records
English Name
Hebrew Name
Relationship to whom
Secular Date of Death
(before or after sundown)
Name of his/her
spouse (if married)
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Havurah
Everything you wanted to know about our TBH Havurah program!!!
What Is A Havurah?
A Havurah is a group of TBH adults who meet, usually at their own discretion,
with or without children, to share Jewish learning and experiences in an
“extended family” setting. Each Havurah decides its own focus. Some
concentrate on religious activities, whereas some are strictly social. Each group
decides how often it will meet, and whether it will emphasize family activities
or concentrate on adult activities. The Havurah experience is for people who
are seeking a smaller scale Jewish community and are willing to give and work
towards building this unique communal bond.
What Does A Havurah Do?
Each Havurah decides its program based on its own needs. One Havurah might
be involved in a self-taught study unit on the Torah, another may be going on
a weekend to Palm Springs, another may be planning a picnic with their kids.
Some Havurot do holiday dinners together and are there to help one another in
good times and bad.
How Do I Join A Havurah?
By completing the ”Havurah Application”, your name will be put on an active
file, meaning that as soon as we receive a sufficient number of applications
from people in your age group with your general interests, you will be notified
of the first meeting date of your Havurah. A member of the Havurah Committee
will help you get started.
All Participants of a Havurah must be Temple Beth Haverim Members
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
2009/2010
Havurah Membership Request
Last Name _ ________________________________________ First Name(s) ______________________________________________
Home Address _______________________________________________________________________________________________
(
)
Phone No. ______________________________
Best time to reach you_________________________________________________
Email _______________________________________________________________________________________________________
Age range: Husband
Wife
❑ Under 30
❑ Under 30
❑ 30-40
❑ 30-40
❑ 40-55
❑ 40-55
❑ 55-65
❑ 55-65
❑ 65+
❑ 65+
Occupation: Male _ _______________________________Female __________________________________
Marital Status: ❑ Married
❑ Single
❑ Divorced
❑ Widowed
Children:
Name
Grade
Do you prefer: (please check)
❑ To be placed with families closer to your age
❑ All adult activities ❑ All family activities
Age
Gender
❑ To be placed with families closer to your children’s ages
❑ Combination
Please check off all interest for the Havurah that are important to you.
❑ Religious ❑ Social ❑ Education ❑ Cultural
List a few special interests or activities you enjoy: __________________________________________________________________
__________________________________________________________________________________________________________
Do you favor a specific type of Havurah?
❑ Family ❑ Single ❑ Intermarried ❑ Senior
List any Temple families you would like to be in a Havurah with: ______________________________________________________
__________________________________________________________________________________________________________
Have you ever been in a Havurah before?
❑ Yes ❑ No
If yes, please describe_________________________________________________________________________________________
__________________________________________________________________________________________________________
Additional comments:________________________________________________________________________________________
__________________________________________________________________________________________________________
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
New Member
Authorization Agreement
2009/2010
We are pleased to offer these automatic services whereby we will deduct equal monthly installments using your Visa,
Mastercard, or American Express on or about the first (1st) day of each month.
Visa/Mastercard/American Express
I hereby authorize TBH to charge my credit card.
Name of Cardholder (please print):_______________________________________________________________________________
Card #:______________________________________________________________________ Exp. Date:_ ______________________
Signature:_______________________________________________________________ Date:_______________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Temple-Related Fees 2009/2010
Total Obligation Due $_________________ less deposit ____________ divided by_ _________ months
Please deduct $ ______________________ in equal monthly installments.
Early Childhood Center-Related Fees 2009/2010
Total Obligation Due $_________________ less ECC deposit fees which include 1st and last month’s
tuition $_ __________ divided by 8 remaining months. Please deduct $_ ________in equal monthly installments.
*
❑ P lease check here if you want to incorporate your High Holy Days pledge into your
monthly installments.
❑ P lease check here if you want to incorporate your Bar/Bat Mitzvah charges when
they are due.
Temple
Date
Ecc
Payments
Date
Payments
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
Temple Beth Haverim
Registration—July 1, 2009 – June 30, 2010
New Member
Please complete STEPS A-F as accurately as possible. If you need any assistance
in completing this form, please call the temple office at (818) 991-7111. We’re here to help!
2009/2010
Last Name______________________________________________
Male First Name_ ________________________________ Female First Name ______________________________________
Step A: Calculate Your Membership Dues
Place an “X” in the box next to your membership category.
1.
❑ $3600.00 Haverim Circle
our generosity will allow for enhancements
Y
to TBH in ways the budget does not allow
2.
❑ $1,300.00 Full Family Children in Hebrew school
3
❑ $1,000.00 Single Parent Family
Children in Hebrew school
4.
❑ $1,500.00 Post B’nai Mitzvah
Children between 14-24 & unmarried
5.
❑ $1,500.00 Couple
No children or all children over 25
6.
❑
$950.00 Young Family Children Kindergarten through oldest child in 2nd grade
7.
❑
$825.00 Early Childhood Center Oldest child PreK and younger in TBH Early Childhood Center
8.
❑ $1,100.00 Jewish Day School Family
9.
❑
$600.00 Associate Family
No children in TBH schools
Full member other Temple-no school or High Holy Day Tickets
10. ❑
$450.00 Couple under 30 years old Oldest member under 30 - No children in TBH Schools
11. ❑
$700.00 Senior Couple Both age 65+
12. ❑
$350.00 Senior Single
Age 65+
13. ❑
$550.00 Single Adult No spouse or children
A1. Please write the amount of your dues from the list above......................................... Net Dues $___________________ Step B: Annual Scrip Commitment
Scrip is a store gift certificate that is worth, dollar for dollar, exactly what it costs you. Using Scrip is just like using cash except that our
Temple office receives a percentage of every dollar of Scrip which it sells. Scrip is available for most of our local markets and many other
stores. Our Temple requires that members purchase Scrip each year as part of their annual commitment. The amount of Scrip which you are
required to buy is based on your membership category. If you prefer not to participate in the Scrip program, you may satisfy your obligation
by making the contribution listed below for your membership category. If you do not complete your Scrip purchases by June 30, 2010,
you will be billed for 5% of the amount of Scrip you did not purchase.
Membership
Category
Scrip Purchase
Amount
Full Family
Single Parent Family
Post B’nai Mitzvah
Couple
Young Family
Early Childhood Center
$4,500.00
$2,500.00
$2,500.00
$2,000.00
$2,500.00
$2,500.00
Contribution
In-Lieu Of Scrip
$225.00
$125.00
$125.00
$100.00
$125.00
$125.00
Membership
Category
Scrip Purchase
Amount
Jewish Day School Family
Associate Family
Couple - 30 yrs old
Senior Couple
Senior Single
Single Adult
$2,500.00
None
$2,000.00
$1,000.00
$500.00
$500.00
Contribution
In-Lieu Of Scrip
$125.00
None
$100.00
$50.00
$25.00
$25.00
Please place an “X: below if you are going to participate in the scrip program. If you do not place an “X” below, your monthly
statement from the Temple will include the required Contribution in Lieu of Scrip for your membership category.
❑ I will participate in the Scrip purchase program and will buy from the Temple the total amount of Scrip as indicated for my
membership category on or before June 30, 2010.
Please complete side 2
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org
Registration (continued)
Please complete side 1 first.
Step C: Calculate the Payment for Children in Youth Groups
C1. Kadima
4th through 6th grades
_____________ x $65.00 = $________________
C2. United Synagogue Youth
7th through 12th grades
_____________ x $80.00 = $________________
(for non-confirmation students)
C3. Please add lines D1and D2
Youth Group Total
$________________
Step D: Calculate Your Religious School Fees for June 1, 2009 – June 30, 2010 ONLY:
Please indicate the number of children you are enrolling in each level and then multiply the number of children by the cost of each class:
0
= $ __________________
0
= $ __________________
Kindergarten ____________ x FREE Hebrew School
K–2nd grades
(Book and Material fees $100)
1st and 2nd grade ____________ x FREE $100.00
Book and Materials Fees ____________ x _______= $ __________________
I am unable to commit to being a parent partner for my child’s class
$160 for year_________ or $40 x ________ no. of quarters
and therefore, I will commit to paying $160.00 for the entire year — or
$40.00 for each quarter that I cannot participate as a parent partner.
Total __________________
Hebrew School
3rd – 7th grades
(Book and Material fees included)
3rd through 6th grade ____________ x $825.00 = $ __________________
7th grade ____________ x $700.00 = $ __________________
Confirmation Program
8th, 9th, & 10th grade ____________ x $465.00 = $ __________________
(U.S.Y. membership included)
Please Total the Tuition Amount Above: Total = $
Step D1:
Step D2: Help a Child Attend Hebrew School:
Because it is in the philosophy of tbh not to deny a child a jewish education, you can help send a child to religious school.
An additional donation will help make that happen. Please indicate the amount you would like to donate = $__________
Step E: Calculate Your Total Obligation For The Year:
Please calculate the total amount due using the following format.
E1. Please write your NET DUES from STEP A on Side 1.
$_ __________________
E2. Security —July 1, 2009-June 30, 2010
$_ __________________
• $300 for #1 through 8 in Step “A” on reverse side
• $250 for #9 through 13 in Step “A” on reverse side
E3. I f you elected to participate in the Scrip program in STEP B on Side 1, please
leave this line blank. Otherwise please write the amount of the Contribution
In-Lieu of Scrip due for your membership category from STEP B on Side 1.
$_ __________________
E4. Please write the YOUTH GROUP TOTAL from Line C4 in STEP C Above.
$_ __________________
E5. Please write the SCHOOL COST from Line D1 in STEP D above.
$_ __________________
E6. Please write the DONATION from STEP D2 above.
$_ __________________
E7. For participation in SISTERHOOD.
$_ __________________
E10. High Holiday Parking/Civic Arts Plaza. Fee due to rising costs of Thousand Oaks Civic Arts Plaza
FREE
FREE
$_ __________________
36
$_ __________________
TOTAL OBLIGATION (Please add the amounts you have written on Lines F1-F-11):
$
E8. For participation in MEN’S CLUB.
E9. For participation in YOUNG SENIORS, please write $18.00 per person.
$_ __________________
A key philosophy of Temple Beth Haverim is that no individual will be refused membership because of inability to pay. If you require special
consideration, please request a Dues Relief Application from the Temple Administrator.
When you return this registration form, a minimum of at least 15% of your TOTAL OBLIGATION is required by May 29, 2009. Once your
registration form is received and processed, the Temple office will send you a confirmation letter with your TOTAL OBLIGATION and the
calculation of your minimum monthly payment for fees and tuition due for the membership year ending June 30, 2010.
Please see “authorization agreement” for payment choices.
Member Signatures __________________________________________________________ Date____________________________
New Member
2009/2010
Schedule Of Classes Grades Kindergarten through 2
Dear Parents:
Beth Haverim means “House of Friends.” It is a place where, together, we teach our children the best
that Judaism has to offer. Our Hebrew School features proven, innovative approaches to Jewish
education in an engaging, relevant, and challenging manner. Our educational goals focus on
individual students needs and interests, adding enrichment in art, music, and family-centric activities.
We provide an environment immersed in the celebration of Jewish life, encouraging the observance of
the holidays and Shabbat, while living ethically and morally in today’s world.
• Kindergarten under the Umbrella of the Early Childhood Center will meet on Wednesdays from
4:15 p.m.-6:15 p.m. or Sundays from 9:30 a.m. - 11:30 a.m.
Please note—for 2009/2010 Hebrew School—Kindergarten will be fully directed by Donna Becker. In the coming
years, Donna will add Grades 1 and 2 to her complete direction, During the 2009/2010 School year Donna will
collaborate with and work closely with the Hebrew School Principal for grades 1 and 2.
In order for your child/children to get the most out of their Kindergarten—2nd grade years—we need you to be
involved. Parent partners will be asked to come to class once a quarter and to provide snack on that day. It will
be a great way for you to see what is going on and to demonstrate the value of Hebrew School.
We ask that you be a partner in the classroom once a quarter. If you are unable to commit to being a
parent partners for your child’s class, we will bill your account $160 for the year or $40 for each quarter
you cannot participate.
• Grades 1 and 2 will meet on Wednesdays from 4:15 p.m. -6:15 p.m. or Sundays from 9:30 a.m. -11:30 a.m.
Please return your completed membership and school registration forms
by Friday, May 29, 2009
We look forward to working with your children and your family.
Shalom,
Donna Becker
Linda Shulman
Director of Early Childhood Center
Vice President of Education
Please Note: Choice of days will be on a first-come first-serve basis
29900 Ladyface Ct. • Agoura Hills, CA 91301 • (818) 991-7111 • Fax (818) 991-2423 • www.templebethhaverim.org