Introduction to Membership Application for Rabbis by moti

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									                       OHALAH: Association of Rabbis for Jewish Renewal

                       Subscription Application for Rabbinic Pastors

Mail the completed application with a check in the amount of $100, payable to OHALAH. Mail the
completed application with a check in the amount of $100, payable to OHALAH, and mail it to
OHALAH c/o Rabbi Yocheved Mintz, 2045 Grouse Street, Las Vegas, Nevada 89134..

Your fee will be deposited into an OHALAH account for the benefit of the Rabbinic Pastor
Association. If, for any reason, your application is not accepted, your fee will be refunded to you.

Please print legibly or type.

GENERAL INFORMATION

Name:

Hebrew Name:

Home address:


city                 state/province               zip/postal code        country

Work address:
                            name of employer

              street address or post office box

city                 state/province               zip/postal code        country

Where do you prefer we send OHALAH correspondence (home or work)?

Home Phone:                                 Work Phone:

Cell Phone:                                Fax No.

E-mail address:

ORDINATION

Please attach a copy of your smicha document. If you have separate Hebrew and English documents,
please attach both.




                                            OHALAH Rabbinic Pastor Subscription Application 5765, page 1   of 2
RECOMMENDATIONS

Please obtain a recommendation from Rabbinic Pastor Ellen Weaver at ElleWeaver@aol.com or 215-
635-6003, or Rabbinic Pastor David Daniel Klipper at daviddaniel@klipper.us or 203-329-9993 in
support of your application.

Name:


PROFESSIONAL ASSOCIATIONS

1. Do you belong to any professional associations?

If so, which one(s)?


2. Have you ever been denied membership in a professional association to which you have applied?


3. Have you ever been suspended, expelled, placed on probation or been subject to other
   disciplinary action by a professional association for any reason other than the non-payment of
   dues?

If you answer yes to question 2 or 3, please explain on a separate sheet.

My answers to the above questions are true and correct to the best of my knowledge. I hereby apply
to become a subscriber to the OHALAH email discussion list.




              Signature                                                  Date




                                            OHALAH Rabbinic Pastor Subscription Application 5765, page 2   of 2
See top of page 1 for where to send this application.




                  OHALAH Rabbinic Pastor Subscription Application 5765, page 3   of 2

								
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