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Membership Application
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Membership Type
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30 and Under
Single 31-35
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Family 36+
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Primary Reason for Joining
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Moved to Atlanta
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Email for Confirmation
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Primary Zip Code
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How Many Family Members (including yourself)
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2
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4
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8
9
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Family Details
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Role in Family
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Head of Household
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Title
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Rabbi
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First Name
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Last Name
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Jewish Status
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Hebrew Name
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Tribe
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Birth Date
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Born After Sunset
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Date of Bar/Bat Mitzvah
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Marital Status
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Date of Marriage
Conversion Date
Conversion Rabbi & Affiliation
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Former Synagogue Affiliation
Concurrent Synagogue Affiliation
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Father's English Name
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Father's Tribe
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Mother's English Name
Mother's Hebrew Name
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Mother's Jewish Status
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How Many Yahrzeit Listings?
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Yahrzeit Listing
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Name of Deceased
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Relationship
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Related to
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Secular Yarzheit Date
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Pass After Sunset
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Hebrew Name
Mon, January 13 2025 13 Teves 5785
