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Member Profile

Personal Information
Your Name*
First Last
Name of Second Adult Household Member
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Adult #1 Cell Phone
Adult #2 Cell Phone
Adult #1 e-mail*
Adult #2 e-mail
If married, wedding anniversary:
Adult #1 Date of Birth
Adult #2 Date of Birth
Business/Occupation Information
Adult #1 - Occupation
Adult #1 - Company
Adult #1 - Work Phone
Adult #1 - Work Email
Adult #2 - Occupation
Adult #2 - Company
Adult #2 - Work Phone
Adult #2 - Work Email
Children and/or Step-Children
Please provide information about children below.
Number of Children
Child #1 - Name
Child #1 - Hebrew Name
Child #1 - Date of Birth
Child #1 - Sex
- Male
- Female
Child #1 - Address (if different)
Street Address Address Line 2 City State ZIP Code
Child #2 - Name
Child #2 - Hebrew Name
Child #2 - Date of Birth
Child #2 - Sex
- Male
- Female
Child #2 - Address (if different)
Street Address Address Line 2 City State ZIP Code
Child #3 - Name
Child #3 - Hebrew Name
Child #3 - Date of Birth
Child #3 - Sex
- Male
- Female
Child #3 - Address (if different)
Street Address Address Line 2 City State ZIP Code
Child #4 - Name
Child #4 - Hebrew Name
Child #4 - Date of Birth
Child #4 - Sex
- Male
- Female
Child #4 - Address (if different)
Street Address Address Line 2 City State ZIP Code
Child #5 - Name
Child #5 - Hebrew Name
Child #5 - Date of Birth
Child #5 - Sex
- Male
- Female
Child #5 - Address (if different)
Street Address Address Line 2 City State ZIP Code
Child #6 - Name
Child #6 - Hebrew Name
Child #6 - Date of Birth
Child #6 - Sex
- Male
- Female
Child #6 - Address (if different)
Street Address Address Line 2 City State ZIP Code
Yahrzeits
If you wish to receive reminders of the death of a loved one, please provide the following information. Year of death MUST be included so that an accurate Jewish date can be determined.
Number of Yahrzeits
Yahrzeit #1
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
Yahrzeit #2
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
Yahrzeit #3
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
Yahrzeit #4
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
Yahrzeit #5
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
Yahrzeit #6
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
Yahrzeit #7
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
Yahrzeit #8
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
Yahrzeit #9
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
Yahrzeit #10
Please include the following information: Name, Hebrew Name, Relationship, Who the person was related to, and the Date of Death (including the year).
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Back to School Assistance for Foster Angels

We are again holding a drive to help foster kids with needed school supplies. This year, like last, our recipient organization will be Foster Angels.

Unlike previous years, since we will not be able to meet in person to stuff backpacks, this will be purely a money-raising drive. It costs about $50 to cover each filled backpack.

We'd like to be able to give our collection to Foster Angels by July 28. How many backpacks can we cover as a community? Last year we filled 40!

Please Paypal your contribution to bookkeeper@kolhalev.com or mail a check to Congregation Kol Halev, 9300 IH-35, Suite A-500 PMB 513, Austin, TX 78748. Thank you for your support!

Personal Information

Business/Occupation Information

Children and/or Step-Children

Yahrzeits