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    Application for Membership July 1, 2011 thru June 30, 2012
    Annual Membership Dues: $100
    Our goal is to become paperless and save trees,
    oxygen and money

    Payment of your membership dues may be completed online
    either by PayPal or Credit Card.

    To enable us to update our records, please complete the following:
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    Member Information

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    First Name
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    Last Name
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    Spouse's First Name
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    Spouse's Last Name
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    Home Address
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    City
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    State
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    Zip Code
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    Congregation Information

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    Congregation Name
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    Address
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    City
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    State
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    Zip Code
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    Miscellaneous Information

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    Would you like to be mentor to a new colleague in the field?
    yes
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    no
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    Would you be interested in leading a workshop?
    yes
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    no
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    If so, in what area(s)?
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    What topics would you be interested in hearing presented and/or discussed at MetroASE meetings?
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    Number of members in your Congregation:
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    Affiliation
    Reconstructionist
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    Reform
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    Conservative
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    Orthodox
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