2025-2026 New Partner Application - Form

Temple Adat Elohim - New Partner Application
July 1, 2025 - June 30, 2026

Thank you for taking the first step in joining the Temple Adat Elohim family. We’re excited to welcome you into our warm, inclusive, and caring community.

At TAE, we believe in building meaningful connections through Jewish learning, spiritual growth, and acts of kindness. Whether you're looking for a place to celebrate, reflect, connect, or give back, there’s a home for you here.

Please take a few moments to complete the form. Required fields are marked with a red asterisk. Once we receive your application, someone from our team will be in touch to personally welcome you.

If you have any questions, please call us at (805) 497-7101. We’re here for you!

PERSON COMPLETING THIS FORM

* Date you would like to join TAE:

* Name of Person Completing This Form (First and Last)

* Email Address (To receive your submission confirmation)

HOUSEHOLD INFORMATION

Residence Information

Optional - Mail Name

ℹ️ We will default to “Mr. & Mrs. Sam G. Levy” for two-adult households. If you don't have a preferred salutation, skip this section.

* Residence Street Address

* City

* State

* Zip

Home Phone

Do you have a different billing address than your residence?

NoYes

* Billing Street Address

* City

* State

* Zip

Household Profile

* Are you married?

Please Select OneYesNo

Marital Status

Wedding Date

* Have you previously been affiliated with another temple?

Please Select OneYesNo

Synagogue Name

Year of Last Affiliation

* Is this temple partnership for a one-adult or two-adult household?

Please Select OneOne-Adult HouseholdTwo-Adult Household

Individual Profile

👉 Adult 1

Title

i.e. Miss, Mrs., Mr., Dr.

* First Name

* Last Name

Hebrew Name

* Cell Phone

* Email Address

* Date of Birth

Gender

Occupation

Business Phone

* How do you identify religiously?

Other, please explain

Did you have a Bar/Bat Mitzvah?

Please Select OneYesNo

Did you have a confirmation?

Please Select OneYesNo

What is your Hebrew fluency?

Please Select OneNoneBeginnerAdvanced

Optional: Anything you would like us to know about you?

👉 Adult 2

Title

i.e. Miss, Mrs., Mr., Dr.

* First Name

* Last Name

Hebrew Name

* Cell Phone

* Email Address

* Date of Birth

Gender

Occupation

Work Phone

* How do you identify, religiously?

* Other, please explain

Did you have a Bar/Bat Mitzvah?

Please Select OneYesNo

Did you have a confirmation?

Please Select OneYesNo

What is your Hebrew fluency?

Please Select OneNoneBeginnerAdvanced

Anything you would like us to know about you? Optional

Child Information

👉 Under Age 18

* Do you have children under age 18?

Please Select OneYesNo

* Child 1 - First Name

* Last Name

Hebrew Name (optional)

* Secular School Name

* Current Grade

* Date of Birth

👉 Child 2

* Child 2 - First Name

* Last Name

Hebrew Name (optional)

* Secular School Name

* Current Grade

Date of Birth

👉 Child 3

* Child 3 - First Name

* Last Name

Hebrew Name (optional)

* Secular School Name

* Current Grade

Date of Birth

👉 Child 4

* Child 4 - First Name

* Last Name

Hebrew Name (optional)

* Secular School Name

* Current Grade

Date of Birth

👉 Child 5

* Child 5 - First Name

* Last Name

Hebrew Name (optional)

* Secular School Name

* Current Grade

Date of Birth

* Do you have children age 18 or older?

Please Select OneYesNo

👉 ADULT CHILD 1

* Adult Child 1 - First Name

* Last Name

* Date of Birth

* Residing with you?

Please Select OneYesNo

* College Student?

Please Select OneYesNo

👉 ADULT CHILD 2

* Adult Child 2 - First Name

* Last Name

* Date of Birth

* Residing with you?

Please Select OneYesNo

* College Student?

Please Select OneYesNo

👉 ADULT CHILD 3

* Adult Child 3 - First Name

* Last Name

* Date of Birth

* Residing with you?

Please Select OneYesNo

* College Student?

Please Select OneYesNo

👉 ADULT CHILD 4

* Adult Child 4 First Name

* Last Name

* Date of Birth

* Residing with you?

Please Select OneYesNo

* College Student?

Please Select OneYesNo

👉 ADULT CHILD 5

* Adult Child 5 First Name

* Last Name

* Date of Birth

* Residing with you?

Please Select OneYesNo

* College Student?

Please Select OneYesNo

Additional Adults

* Are there additional adults residing in your household?

Please Select OneYesNo

* Number of additional adults:

Please Select One123

* Adult 1 First Name

* Last Name

* Age

* Relationship

* Adult 2 First Name

* Last Name

* Age

* Relationship

* Adult 3 First Name

* Last Name

* Age

* Relationship

💖 YAHRZEIT REMEMBRANCES

A Yahrzeit is the annual remembrance of a loved one’s death.

Each year, we will send you a reminder and honor their memory by reading their names during services. Please list the names of loved ones for whom you would like to receive Yahrzeit reminders

👉 Start by clicking the + button to enter a name. Click the + again to add additional names.

Select the “+” button for each name you wish to include.

* First Name

* Last Name

* Related to - First name

* Related to - Last name

* Relationship

* Date of Death

* After sunset?

Optional: Burial Date

* Do you wish to observe the Hebrew or secular date?

Please Select OneHebrewSecular

TAE PARTNERSHIP LEVELS

Our various levels have been designed to meet the needs of our congregants.
👉 Levels explained:

The Sustainer level reflects the average annual cost per family to support temple operations. We encourage everyone to join at this level.
The Builder level is for those who can contribute above the Sustainer level. Your generosity helps us offer financial assistance to those who need support, including young families and seniors.
The Congregant and Partner levels are for those who wish to join but cannot commit at the Sustainer or Builder levels.
Click here to learn more >>

👉 Please note:

Tuition for the Gallant-Schiff Infant Center, Early Childhood Center, and Religious School, as well as security and facilities fees, is not included in any partnership level.
The Partner level is the minimum required to enroll in our Religious School.
All partnership contributions are 100% tax-deductible to the fullest extent the law allows.
Fiscal Year: Temple Adat Elohim’s fiscal year runs from July 1, 2025, to June 30, 2025. Billing will begin on July 1, 2026

* Choose your preferred partnership level:

ADDITIONAL FEES

Security Fee
We provide measures such as professional security guards, secured gates, surveillance systems, and more. This fee supports our ongoing efforts to maintain and enhance campus security.

* Please select the security fee category that applies to you:

Please Select OneNot an Early Childhood Center (ECC) family: $575/yearECC or Infant Center Family: $1,200/yearAssociate Level - $0/yearMarried-by-Clergy: $0/for first year

Facilities Fee
To support the ongoing costs of maintaining and improving our temple campus, we ask all temple partners to contribute an annual facilities fee of $180. This $15 per month contribution is important in keeping our campus clean, safe, and welcoming for all.

* 👉 I understand that each household is required to pay an $180 annual facilities fee to support the maintenance and improvement of the temple campus, and I acknowledge this requirement. Please check the box to the left

👉 I understand that each household is required to pay an $180 annual facilities fee to support the maintenance and improvement of the temple campus, and I acknowledge this requirement. Please check the box to the left

School Tuition
The Gallant-Schiff Infant Center, Early Childhood Center, and Religious School require separate tuition and are billed independently from the temple partnership dues. For more information, please contact the Infant or Early Childhood Center at (805) 497-6920 or the Religious School office at (805) 497-0361.

* 👉 I acknowledge that enrollment in the Gallant-Schiff Infant Center, Early Childhood Center, and Religious School requires an additional fee. If I am interested or would like to enroll, I will contact the appropriate office for further information. You can call the temple office to find out more. Please check the box to the left.

👉 I acknowledge that enrollment in the Gallant-Schiff Infant Center, Early Childhood Center, and Religious School requires an additional fee. If I am interested or would like to enroll, I will contact the appropriate office for further information. You can call the temple office to find out more. Please check the box to the left.

YOUR CONNECTIONS AND INTERESTS

We ask about your interests to help connect you with the programs, groups, and opportunities that matter most to you, so you feel welcome, engaged, and at home from the start.

Please help us by completing this next section so we can get to know you better and support your journey in our community.

How did you hear about Temple Adat Elohim?

If a partner is a friend, please indicate their name. Otherwise, please skip.

Volunteer interests (Check all that apply):.

Social Action (Tikkun Olam) ProjectsHoliday CelebrationsMusic or Chorale OpportunitiesShabbat Services (i.e. ushering, greeting)Please contact me as needed.

Are you interested in hearing from any of the following groups or departments? (Select all that apply.)

COMMUNICATION

As part of our commitment to sustainability and reducing waste, we’ve gone paperless for most communications.

Would you like to opt into receiving paper mail?

NoYes

GOT MATCH?
Did you know your employer may match your donation to Temple Adat Elohim, a 501(c)(3) nonprofit? It’s an easy way to double (or maybe even triple) your impact.

Does your employer offer contribution matching?

NoI am not sureYes! Please contact me.

TERMS

* I have read and fully agree to the terms below (please enter your full name):

The undersigned hereby represents, warrants, and agrees that:
(i) they have read and understood the contents of this Application;
(ii) all information provided to Temple Adat Elohim (TAE) is true and correct as of the date submitted;
(iii) they agree to be bound by the terms herein, including the payment of the Partnership Commitment and any other applicable fees as they become due;
(iv) they will abide by the bylaws, rules, and regulations of TAE, as currently in effect and as may be amended in the future;
(v) they grant TAE the right to publish and republish photographs and videos taken of them and their family at TAE events. Such publications may include, but are not limited to, TAE’s e-newsletter, website, social media, printed materials, and local or national media; and
(vi) they consent to the inclusion of the information provided on this form in a community roster that is distributed only within the TAE community.

The undersigned further authorizes TAE to use such photographs and videos solely for purposes consistent with the mission and operations of the congregation.

CONTRIBUTION DETAILS AND NEXT STEPS
Below is your estimated annual contribution amount. If you join the temple mid-year, your contribution will be prorated. After you submit this form, a member of our accounting team will contact you to confirm your final amount and assist with setting up a payment plan.

💫 Please note: You will not be billed until your total contribution has been reviewed and confirmed.

Estimated Annual Dues

Please remember to click the SUBMIT button at the bottom of the form to finalize your application.