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West Side Institutional Synagogue New Member Form
Please verify reCaptcha before submitting the form.
PRIMARY MEMBER INFORMATION
*
First Name
*
Last Name
*
Birthday
Hebrew Name
Father's Hebrew Name
Mother's Hebrew Name
*
Email
Mobile Phone
B'nai Mitzvah Date
B'nai Mitzvah Parsha
Bereshis
Noach
Lech Lecha
Vayera
Chayei Sara
Toldos
Vayetzei
Vayishlach
Vayeshev
Miketz
Vayigash
Vayechi
Shemos
Vaera
Bo
Beshalach
Yisro
Mishpatim
Terumah
Tetzaveh
Ki Sisa
Vayakhel
Pekudei
Vayikra
Tzav
Shmini
Tazria
Metzora
Achrei Mos
Kedoshim
Emor
Behar
Bechukosai
Bamidbar
Nasso
Beha'aloscha
Sh'lach
Korach
Chukas
Balak
Pinchas
Matos
Masei
Devarim
Vaeschanan
Eikev
Re'eh
Shoftim
Ki Seitzei
Ki Savo
Nitzavim
Vayeilech
Ha'Azinu
Vayakhel-Pekudei
Tazria-Metzora
Achrei Mos-Kedoshim
Behar-Bechukosai
Chukas-Balak
Matos-Masei
Nitzavim-Vayeilech
Vezos Haberakhah
Select One
*
Gender
N/A or Unknown
Male
Female
Tribe (Cohen/Levi/Yisrael)
Cohen
Levi
Yisroel
None Set
COMMUNITY INTERESTS
Please let us know if you are interested in getting involved with any of the following.
Womens League
Youth Programming
Programs and Events
Chesed Committee
ADDITIONAL MEMBER INFORMATION
*
Is there more than one Adult Member on your Member Account?
Please Select One
Yes
No
*
Marital Status
Single
Married
Engaged
Divorced
Widowed
Separated
N/A
Partnered
Anniversary Date
(if applicable?)
SECONDARY MEMBER INFORMATION
*
First Name
*
Last Name
*
Birthday
Hebrew Name
Father's Hebrew Name
Mother's Hebrew Name
*
Email
Mobile Phone
B'nai Mitzvah Date
B'nai Mitzvah Parsha
Bereshis
Noach
Lech Lecha
Vayera
Chayei Sara
Toldos
Vayetzei
Vayishlach
Vayeshev
Miketz
Vayigash
Vayechi
Shemos
Vaera
Bo
Beshalach
Yisro
Mishpatim
Terumah
Tetzaveh
Ki Sisa
Vayakhel
Pekudei
Vayikra
Tzav
Shmini
Tazria
Metzora
Achrei Mos
Kedoshim
Emor
Behar
Bechukosai
Bamidbar
Nasso
Beha'aloscha
Sh'lach
Korach
Chukas
Balak
Pinchas
Matos
Masei
Devarim
Vaeschanan
Eikev
Re'eh
Shoftim
Ki Seitzei
Ki Savo
Nitzavim
Vayeilech
Ha'Azinu
Vayakhel-Pekudei
Tazria-Metzora
Achrei Mos-Kedoshim
Behar-Bechukosai
Chukas-Balak
Matos-Masei
Nitzavim-Vayeilech
Vezos Haberakhah
Select One
*
Gender
N/A or Unknown
Male
Female
Tribe (Cohen/Levi/Yisrael)
Cohen
Levi
Yisroel
None Set
COMMUNITY INTERESTS
Please let us know if you are interested in getting involved with any of the following.
Womens League
Youth Programming
Programs and Events
Chesed Committee
HOME ADDRESS INFORMATION
*
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
*
Zip
Home Phone
(if applicable)
CHILDREN INFORMATION
*
Do you have unmarried Children in your household?
Please Select One
Yes
No
*
How many Children?
Please Select One
1
2
3
4
5
6
CHILD 1 INFORMATION
*
Child's Name
Child's Hebrew Name
*
Date of Birth
*
Gender
B'nai Mitzvah Date
B'nai Mitzvah Parsha
CHILD 2 INFORMATION
*
Child's Name
Child's Hebrew Name
*
Date of Birth
*
Gender
B'nai Mitzvah Date
B'nai Mitzvah Parsha
CHILD 3 INFORMATION
*
Child's Name
Child's Hebrew Name
*
Date of Birth
*
Gender
B'nai Mitzvah Date
B'nai Mitzvah Parsha
CHILD 4 INFORMATION
*
Child's Name
Child's Hebrew Name
*
Date of Birth
*
Gender
B'nai Mitzvah Date
B'nai Mitzvah Parsha
CHILD 5 INFORMATION
*
Child's Name
Child's Hebrew Name
*
Date of Birth
*
Gender
B'nai Mitzvah Date
B'nai Mitzvah Parsha
CHILD 6 INFORMATION
*
Child's Name
Child's Hebrew Name
*
Date of Birth
*
Gender
B'nai Mitzvah Date
B'nai Mitzvah Parsha
YAHRZEIT INFORMATION
*
Do you have Yahrzeits to add to your account?
Please Select One
Yes
No
*
How many Yahrzeits?
Please Select One
1
2
3
4
5
6
YAHRZEIT INFORMATION
*
Full Name
*
Relationship to the Deseased
Hebrew Name
*
Gregorian Date of Passing
This date will calculate the Hebrew Date
*
After Sundown?
Please Select One
Yes
No
YAHRZEIT INFORMATION
*
Full Name
*
Relationship to the Deseased
Hebrew Name
*
Gregorian Date of Passing
This date will calculate the Hebrew Date
*
After Sundown?
Please Select One
Yes
No
YAHRZEIT INFORMATION
*
Full Name
*
Relationship to the Deseased
Hebrew Name
*
Gregorian Date of Passing
This date will calculate the Hebrew Date
*
After Sundown?
Please Select One
Yes
No
YAHRZEIT INFORMATION
*
Full Name
*
Relationship to the Deseased
Hebrew Name
*
Gregorian Date of Passing
This date will calculate the Hebrew Date
*
After Sundown?
Please Select One
Yes
No
YAHRZEIT INFORMATION
*
Full Name
*
Relationship to the Deseased
Hebrew Name
*
Gregorian Date of Passing
This date will calculate the Hebrew Date
*
After Sundown?
Please Select One
Yes
No
YAHRZEIT INFORMATION
*
Full Name
*
Relationship to the Deseased
Hebrew Name
*
Gregorian Date of Passing
This date will calculate the Hebrew Date
*
After Sundown?
Please Select One
Yes
No
2025 MEMBERSHIP CONTRIBUTION
We invite you to make a gift from the heart.
We sincerely thank those who are able and willing to give towards the financial support of WSIS. We understand all family and individual members are different and encourage you to select a Membership Level that is both meaningful and appropriate for you.
All levels provide the option to pay all at once or in installments.
(Choose this option on the payment page)
Membership Type
Benefits
Annual Rate
Etz Chaim Membership
Membership, Kiddush Sponsorship, Annual Dinner Tickets, Mishloach Manot, Shiur Sponsorship, Kiddush Club Membership, and 6 High Holiday Seats
$7,500
Ner Tamid Membership
Membership, Kiddush Sponsorship, Dinner tickets, and 4 High Holiday Seats
$5,000
Chai Membership
Membership, Kiddush Sponsorship, and 2 High Holiday Seats
$3,600
Family Membership
Membership and 2 High Holiday Seats
$2,075
Couple Membership
Membership and 2 High Holiday Seats
$1,600
Young Couple Membership
Membership and 2 High Holiday Seats
(combined age under 60)
$1,250
Individual Membership
Membership and 1 High Holiday Seat
$1,025
Non-Residential
Couple Membership
Membership for those living outside Manhattan who wish to remain part of the community
$500
Non-Residential
Individual Membership
Membership for those living outside Manhattan who wish to remain part of the community
$360
*
My/Our Membership Type
Please Select a Membership Type
Etz Chaim Membership | $7,500
Ner Tamid Membership | $5,000
Chai Membership | $3,600
Family Membership | $2,075
Couple Membership | $1,600
Young Couple Membership | $1,250
Individual Membership | $1,025
Non-Residential Couple Membership | $500
Non-Residential Individual Membership | $360
SECURITY ASSESSMENT CONTRIBUTION
Security Assessment Fee (Required) | $250
Security Assessment Fee (Required) | $180
ADDITIONAL COMMUNITY CONTRIBUTIONS
In addition to your Membership Pledge, WSIS joins other Upper West Side synagogues in supporting the following community institutions. Please help our shul to contribute its share by including a donation for each of these causes.
Shul Security Fund
This Fund helps to keep our community's facilities and institutions safe. For more information, please visit
Community Security Service
.
Shul Security Fund Contribution | $100
Opt In
Opt Out
Eruv
The eruv facilitates our mobility on Shabbat. For more information, please visit
Manhattan Eruv
.
Eruv | $100
Opt In
Opt Out
Mikvah
The West Side Mikvah facilitates our observance of taharat mishpacha and tevilat keilim. For more information, please visit
Westside Mikvah
.
Mikvah Contribution | $100
Opt In
Opt Out
Yoetzet Halacha
WSIS sponsors the Manhattan Yoetzet Halacha Initiative. For more information, please visit
Nishmat's
Yoatzot Halacha
.
Yoetzet Halacha Contribution | $100
Opt In
Opt Out
Misaskim
WSIS supports the Misaskim Initiative. For more information, please visit
Misaskim's Support with a Heart
.
Misaskim Contribution | $100
Opt In
Opt Out
West Side Hatzoloh
WSIS supports the West Side Hatzoloh volunteer Ambulance Corps. For more information, please visit
West
Side Hatzoloh
.
West Side Hatzoloh Contribution | $100
Opt In
Opt Out
TOTAL DUE
All financial donations are tax-deductable as allowable by law. As always, all financial information is confidential. Once this form is completed, you will be asked to set a password to complete the set up of your WSIS member account.
Wed, April 30 2025 2 Iyyar 5785
