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Membership Form 2020



A Conservative Congregation
Affiliated with the United Synagogue of Conservative Judaism

3919 Moran Road, Tampa, Florida 33618
813-962-6338
B'ruchim Habaim: Welcome to Congregation Kol Ami


Membership Information Form

We are delighted that you are interested in Congregation Kol Ami. It is our hope that new members will feel welcomed, at home, and a part of our congregational family. If there is anything on this form that you have questions about or are not sure how to answer, just let us know and/or fill it out to the best you can. Thank you for taking the time to give us your information. 

                                         PERSONAL INFORMATION                                 

Please select all that apply
Please Select All that Apply

Please include your name, your father's name & your mother's name
Example: Isaac ben Abraham v'Sarah (ben = son of, bat = daughter of; v = and)

Please include your name, your father's name & your mother's name
Example: Isaac ben Abraham v'Sarah (ben = son of, bat = daughter of; v = and)


                                     ADDRESS                                     

All mail will be sent to  your residence unless otherwise requested.

Mailing address (if different)


                                      FAMILY INFORMATION                                     

* Applies to each of your children who reside with you.

1st Child

2nd Child

3rd Child

4th Child


                             MISCELLANEOUS INFORMATION                              

                        VOLUNTEER OPPORTUNITIES                   

We  welcome our members to become involved in Synagogue life and activities.
Please check any activities that interest you.  We will be in touch!

Sat, January 16 2021 3 Shevat 5781