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Non-Member Access Request Application
Adat Yeshurun Reserves the right to restrict admission to our property. All non-members must request access to the property by submitting this form to the Synagogue office.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Where are you from?
*
Your answer
Please state the reason for your visit to our premises.
*
To Attend Services
To use the Keilim Mikvah
I have an appointment with the Rabbi or other staff member
Required
If you are attending Services, please select which of the following minyan you are requesting to attend
*
Friday Night Mincha and Kabbalat Shabbat
Shabbat Morning - 9:00 AM
Shabbat Afternoon Mincha
Motzei Shabbat Maariv
Weekday service
All of the above
Other:
Required
Please enter the dates you are requesting access
*
Your answer
Are you a member of another Synagogue?
*
Yes
No
What is the name and contact information for your Rabbi, or Synagogue?
*
Your answer
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