Membership Application

Become a Bais Moshe member

Complete the membership application, Yom Tov seat details, payment preference, and signature in one place on the Bais Moshe site.

Family membership

$400

Included seats

Non-member seats

$250

Application Summary

Pricing updates as you choose membership and seats.

Select a membership option below to see the total.

Total amount$0

Personal Information

Tell us about yourself and your family.

Basic Information

Full Name

Hebrew Birthday

Contact Information

Email Address

Phone Number

Address Information

Street Address

City

State

ZIP Code

Hebrew Names

Father's Hebrew Name

Mother's Hebrew Name

Spouse Information

Information about your spouse, if applicable.

Basic Information

Spouse Name

Spouse Hebrew Birthday

Hebrew Names

Spouse Father's Hebrew Name

Spouse Mother's Hebrew Name

Yartzeit Information

Memorial dates for family members.

Applicant's Parents Yartzeit

Not applicable

Father's Yartzeit

Date

Father Name

Father's Father Name

Mother's Yartzeit

Date

Mother Name

Mother's Mother Name

Spouse's Parents Yartzeit

Not applicable

Spouse Father's Yartzeit

Date

Father Name

Father's Father Name

Spouse Mother's Yartzeit

Date

Mother Name

Mother's Mother Name

Membership Options

Choose your membership type and Yom Tov seat preferences.

Choose Your Option

Enter your full name above to choose a membership option.

For Deli Minyan membership, please use the dedicated Deli Minyan membership site.

Deli Membership

Payment

Pay now by card, or split membership into monthly installments.

Select a membership option and seats to see pricing.

Total$0

Secure card payment

No card is needed until your membership selections have a balance due.

Signature

Complete your application.

Digital Signature

By typing your name above, you acknowledge that this serves as your digital signature and that all information provided is accurate.