November 28, 2022 -

  • 419.517.8400

CBI Membership Form

Thank You for Your Interest in
Congregation B'nai Israel

Please fill out the the form below and click on the “Submit” button when you are finished. If you have questions, please contact our Membership and Community Outreach Coordinator, Rhoda Miller at

CBI Membership Form

Application for membership at Congregation B'nai Israel, Sylvania, Ohio.
  • Member "A" Information

    Member "A" must be Jewish
  • All Jews identify as being a Kohen (a descendant of Aaron), or Levite (from the tribe of Levi), or simply an Israelite, a Jew with no particular tribal affiliation.
  • Use English letters, include "ben" or "bat"
  • Member "B" Information

    Member "B" is spouse/partner of Member "A"
  • Only fill out if address is different from Member "A" Primary Address.
  • All Jews identify as being a Kohen (a descendant of Aaron), or Levite (from the tribe of Levi), or simply an Israelite, a Jew with no particular tribal affiliation.
  • Use English letters, include "ben" or "bat"
  • Second Home Information

    If you have a second home, please complete this information.
  • Children's Information

  • Use English letters, include "ben" or "bat"
  • Use English letters, include "ben" or "bat"
  • Use English letters, include "ben" or "bat"
  • Use English letters, include "ben" or "bat"
  • Use English letters, include "ben" or "bat"
  • Yahrzeit Information

    If you wish to be notified for a yahrzeit, please fill out the following information.
  • The Hebrew calendar date changes after sundown each day. In order to calculate the correct Hebrew date of death, please indicated whether the deceased passed before or after sundown.
  • The Hebrew calendar date changes after sundown each day. In order to calculate the correct Hebrew date of death, please indicated whether the deceased passed before or after sundown.
  • The Hebrew calendar date changes after sundown each day. In order to calculate the correct Hebrew date of death, please indicated whether the deceased passed before or after sundown.
  • The Hebrew calendar date changes after sundown each day. In order to calculate the correct Hebrew date of death, please indicated whether the deceased passed before or after sundown.

Congregation B'nai Israel
6525 Sylvania Avenue, Sylvania, Ohio 43560
419.517.8400|Email Us