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Affiliation Form
Mission Statement
Shir
Ami
is the heart of Reform Judaism in Bucks County, PA. We are
dedicated
to sustaining and growing a vibrant and diverse Jewish community. We are
devoted
to educating all who seek a greater understanding of our tradition, practices, and values. We are
committed
to connecting with each other, cultivating spiritual growth, creating a just and compassionate society, and supporting Israel and our Jewish family worldwide.
Personal Information
*
Adult A:
Please Select One
Mr.
Mrs.
Ms.
Dr.
Other
Preferred Pronoun:
*
First Name:
*
Last Name:
*
Email address:
*
Home Address:
*
City:
*
State:
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*
Zipcode:
*
Cell Phone:
*
Date of Birth:
*
Marital Status:
Please Select One
Single
Married
Divorced
Widowed
Partnership
Date of Marriage (if applicable):
Hebrew Name:
*
Religious Background
Please Select One
Jewish
not Jewish
*
Occupation:
Employer:
Business Phone:
Adult B:
Mr.
Mrs.
Ms.
Dr.
Other
Preferred Pronoun:
First Name:
Last Name:
Email:
Cell Phone:
Date of Birth:
Hebrew Name:
Religious Background:
Jewish
not Jewish
Occupation:
Employer:
Business Phone Number:
Dependent Children:
Family members include single children 30 years old or younger.
Name:
Gender (identifies as):
Male
Female
Hebrew Name:
Date of Birth:
Grade as of Sept. 1
PreSchool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Name:
Gender (identifies as):
Male
Female
Hebrew Name:
Date of Birth:
Grade as of Sept. 1
PreSchool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Name:
Gender (identifies as):
Male
Female
Hebrew Name:
Date of Birth:
Grade as of Sept. 1
PreSchool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Name:
Gender (identifies as):
Male
Female
Hebrew Name:
Date of Birth:
Grade as of Sept. 1
PreSchool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Friends and Family in the Congregation:
Name:
Relationship:
Name:
Relationship:
Name:
Relationship:
Yahrzeit Information:
If you have any questions about Yahrzeit observance, please contact the office at 215-968-3400.
Name of Deceased:
Relationship to whom:
Secular Date (Month/Day/Year)
Preferred Date to Observe:
Secular
Hebrew
Name of Deceased:
Relationship to whom:
Secular Date (Month/Day/Year)
Preferred Date to Observe:
Secular
Hebrew
Name of Deceased:
Relationship to whom:
Secular Date (Month/Day/Year)
Preferred Date to Observe:
Secular
Hebrew
Name of Deceased:
Relationship to whom:
Secular Date (Month/Day/Year)
Preferred Date to Observe:
Secular
Hebrew
Prior Synagogue Affiliation and Dates:
Are there any expectations, special needs or concerns you would like to share with us?
Get involved at Shir Ami!
Please share your interests with us! Your experience and involvement will make Shir Ami stronger. Our community thrives when we all participate and connect with one another.
Auxilaries:
Men's Club
Shir Ami Active Adult Kehillah (ShAAK): 65+
SHAFTY (Youth Group Programs)
Women of Shir Ami (WoSA)
Committees/Leadership:
Building and Grounds
Chesed Committee (Pastoral Care)
Early Learning Center Committee
Education Committee
Engagement Committee
Finance/Budget/ Investment Committee
Membership Committee
Religious School Committee
Ritual Life Committee
Philanthropy Committee
Tikkun Olam Committee
Tikkun Olam/Volunteering:
Caring for Friends
Code Blue (Homeless Shelter Support)
Food Bank
Diversity and Inclusion
Jewish Relief Agency
Reach Out Foundation (Wednesday Lunches)
Religious Action Center- PA
Social Justice/ Action
Voter Engagement
Other Interests:
Mahjong
Interfaith Programming
Theater Group
Small Groups (ShirGroups are small groups are based on common interested, hobbies, and/or demographics. Members gather together in these groups to share in range of activities and experiences.)
Baking
Born in the 1950s
Bourbon Appreciation
Empty Nesters
Interfaith Families
Museums and Culture
Shabbat Dinners
Wine Appreciation
*If you are interested in one of the small group topics, please email
nstandig@shiramipa.org
for information.
Are there any skills, talents, or other interests you would like to share with us?
What are you looking for from your Jewish Community?
I hereby apply for affiliation at Shir Ami Congregation. I agree to pay the annual affiliation commitment, religious school tuition, building fund and any other assessments as set by the Board of Directors. I agree to abide by the constitution and by laws which are available in the members portal of the website or in the synagogue office. Synagogue affiliation entitles those named on this application to participate in all Shir Ami events, ritual experiences, engagement opportunities, and high holiday services.
I hereby apply for affiliation at Shir Ami Congregation. I agree to pay the annual affiliation commitment, religious school tuition, building fund and any other assessments as set by the Board of Directors. I agree to abide by the constitution and by laws which are available in the members portal of the website or in the synagogue office. Synagogue affiliation entitles those named on this application to participate in all Shir Ami events, ritual experiences, engagement opportunities, and high holiday services.
I permit Shir Ami to use photographs and videos of myself, and my family members, in Shir Ami's promotional, marketing, program materials and media.
I give Shir Ami permission to obtain records from my previous synagogue.
I give Shir Ami permission to add my mobile number to a messaging platform about programs/events
How would you like to receive outreach from the clergy, Shir Ami staff, or congregational lay leaders?
Meeting
Phone Call
Email
Thu, April 17 2025 19 Nisan 5785