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YICBH 5785 New Member Application

Welcome to the
Young Israel Congregation,
(also known as YICBH)

Located in beautiful Surfside, Florida, and serving the Communities of Bal Harbour, Bay Harbor Islands, Indian Creek, and Surfside.


NOTE: All New Member Applications are provisional pending approval from our Rabbi.

We ask you to answer the questions on this form so we can update our database with your current address, names of immediate family members, and gabbai / yahrzeit information. 

At the bottom of this form you will be able select the appropriate membership type to pay for dues, fees, and High Holiday seats.

Thank you for joining our YICBH family.

For technical help with form issues, email Jared Plitt

INFORMATION: ADULT 1

ENGLISH NAME


OTHER DETAILS

INFORMATION: ADULT 2 

ENGLISH NAME


OTHER DETAILS

ADDRESS INFORMATION


PRIMARY ADDRESS


SECONDARY ADDRESS

CHILDREN'S INFORMATION

Children's Information
English Name
Hebrew Name
Date of Birth

GABBAI INFORMATION

YAHRZEITS

English Name & Relationship
Hebrew Name (transliterated)
English Yahrzeit Date
Hebrew Yahrzeit Date

MEMBERSHIP DUES AND FEES

Required- 5785 Dues
                                                      

  Family Membership

  $1,550

  Single Membership

  $1,150

  New Members 40 and Below

 

  $500 first year,
 


Required- 5785 Fees
                                                      

  Security Assessment

  $300

  Eruv Council Dues

  Included

  Building Repair and Reserve Fund

  $3,600 (payable in installments beginning within  3 years of membership ).


Optional- High Holiday Seats
                                                      

 Permanent Seats

  Included

 Member High Holiday Seats

 $125 per

Non-Member High Holiday Seats

 $360 per

TOTAL OF REQUIRED AND OPTIONAL DUES AND FEES:

 

   Permanent seats needed, Men - (No additional charge)
   Permanent seats needed, Women - (No additional charge)NOTE- This selection is for Permanent Seat holders only, please.
   Member High Holiday seats, Men - $125
   Non-Member High Holiday seats, Men - $360
   Member High Holiday seats, Women - $125
   Non-Member High Holiday seats, Women - $360
Sun, June 15 2025 19 Sivan 5785