Membership Form — Sharone Hadassah

We cordially invite you to become a member of the Sharone Chapter of Hadassah and enjoy the benefits of friendship, learning, and doing good deeds for Israel and the Jewish People. You may also use this form to enter a gift membership for a daughter, granddaughter, niece, or friend.

Please complete the following form, print out, and mail
with your check made payable to Sharone Hadassah.

Mail to: Sharone Hadassah, P.O. Box 18491, San Jose, CA 95158-8491

Thank you for joining Sharone Hadassah, and welcome!

I wish to contribute
an Annual Membership (dues: $36) -- first time renewal
a Life Membership (one-time dues payment of $360)

This membership is for me a GIFT for the new member named below
New (or Renewing) Member's Name:
Spouse:
Address:
City, State, Zip:
Day Phone: Evening Phone:
Email:

Birthday: (year optional!) Anniversary:
Children (note if Hadassah Member):

Payment Enclosed: Amount:
Payment Method: Check (# ) or
Credit Card: VISA MasterCard
Credit Card Number: Exp Date: Signature:

If this is a gift membership, please put the gift-giver's contact information below:

Gift Giver's Name:
Spouse:
Address:
City, State, Zip:

Day Phone: Evening Phone:
Email:

Interests (check as many as apply):

Current Events	Judaism	Study Groups	Health & Women's Issues
Theatre Parties	Dining Out	Family Events	Outdoor Activities
Book Group	Mah Jongg/Bridge	Stitchery/Crafts
Other

Skills & Talents (check as many as apply):

Event Planning	Educational Programming	Fund-Raising
Leadership Development	Artistic Activities	Record-Keeping
Administration (Mailings, Accounting, etc.)	Other

Sharone Chapter would like to reach out to other women in the community who might be interested in Hadassah.

Please share the name(s) of those who might be interested in becoming a member.

Name:
Phone:
Email: