Friends of the HUB 2024-2025 - Form

Friends of the HUB 2024-2025

Adult Applicant A (Primary)

Title

Last Name

First Name

Marital Status

Anniversary

Hebrew Name

Date of Birth

Birth Place

Are you a Veteran?

YESNO

Email Address

Cell Phone

Occupation

Business Name

Business Phone

Business Address

Address, City, State, Zip

Languages Spoken

Religious Background

Adult Applicant B (Secondary)

Title

Last Name

First Name

Hebrew Name

Date of Birth

Birth Place

Are you a Veteran?

YESNO

Email Address

Cell Phone

Occupation

Business Name

Business Phone

Business Address

Address, City, State, Zip

Languages Spoken

Religious Background

Whether you're a member of Temple Beth Am, a follower of a different faith, or someone with no religious affiliation at all, you are welcome to join us at the Hub and be a part of our thriving arts scene. Our doors are open to all who share a love of creativity and a desire to be a part of something very special.

Are you a member of Temple Beth Am?

YESNO

Are you a member of another temple/church?

YESNO

What is the name of the temple/church?

CONTACT INFORMATION

How would you like your name(s) to appear on HUB mailings?

Home Phone Number

Address

Apt., Suite, Etc..

City

State

Zip Code

Friends of the HUB LEVELS

Friends of The Hub membership offers a wide range of benefits that allow you to truly connect with the programming at this amazing space. As a member, you will enjoy perks such as free admission for you and your guests, discounts on dining and beverages at The Hub, and much more. Become a "Friend of The Hub" today to guarantee your spot at various programs, films, and shows. We invite you to schedule a tour of The Hub.

Total Due:

Payment Options

Pay Friends of the HUB in Full NowMonthly Payment Plan

Total Due

If paying by credit card please consider making a Voluntary 2.5% donation to help defray the costs which Temple Beth Am incurs in connection with processing credit card payments.

Add Donation Amount Here

Payment Authorization

Authorization for Temple Beth Am to charge my Credit Card or debit my checking/savings account for my Friends of the HUB membership options above.

I authorize Temple Beth Am to charge my Credit Card for my account balance based on the Payment Plan selected above.I authorize Temple Beth Am to debit my Checking/Savings Account for my account balance based on the Payment Plan selected above.

Signature

Date

Please take this opportunity to tell us "Who You Are"
What are your passions and interests?

Adult Applicant A- Other Interests?

Please list

Adult Applicant B- Other Interests?

Please list