New Member Application

2023 Membership

If you would like to pay by check, please print this PDF copy of the membership application, and mail it, with your check, to:

Bet Knesset Bamidbar
Attn: Edith Einhorn
PO Box 33503
Las Vegas NV 89133

To pay by credit card, please complete the form below:

Membership Type(Required)

Member #1 Name(Required)

First Last

Member #2 Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Member #1 Email(Required)

Member #2 Email

Member #1 Birthdate

Member #2 Birthdate

Anniversary Date

Yahrzeit Information (We will notify you when names will be read at services)

Name

Relationship to Whom

Yahrzeit Date*

*Select which calendar English or Hebrew you want us to use for your Yahrzeits. If you can, give us actual date including year, either in Hebrew or English.

More Information

I/ We are very interested in participating in BKB activities in addition to attending services. Would you please provide me/us with more information?

Payment Information

Additional contribution to cover the credit card convenience fee

Price: $0.00

Total

Credit Card

Cardholder Name

Card Details

Billing Information

Billing Name(Required)

First Last

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

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Contact Us

PO Box 33503
Las Vegas NV 89133
702-389-6929
bkblvtemple@gmail.com

New Member Application

2023 Membership

Payment Information

Billing Information

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