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Makom Membership Form
Makom is a Jewish community rooted in collective liberation, the lands we live on, and a wellspring of Jewish traditions. We are anti-Zionist and boldly led by queer and trans people. All Jewish people and beloveds are welcome to join in creating spaces for ritual and practice, joy and celebration, mutual support, and learning.
Who is eligible to be a member?
Makom membership applies to an individual or a shared / family membership with whomever you share your life or make family. Membership is open to those who want to join our community; are 12 years old or older; and who live, work, go to school, organize, or are rooted in this area. Learn more about Makom's values and what membership means
here
.
Membership Sustaining Contributions:
Our membership sustains our community and it is essential that money not be prohibitive to joining Makom. We use a sliding scale model and allow individuals to determine the amount of their “sustaining contribution” to our community.
To determine your sustaining contribution, please consult
this document
before filling out the form.
Contact Information
Primary Member Name (does not need to be legal name)
*
First Name
Last Name
I also go by
How do you pronounce your name?
Email
*
Verify Email
*
Secondary Email
Verify Email
Phone Number
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Date of Birth
*
(mm/dd/yyyy)
Pronouns (ex. she/her; they/them)
Membership Type
*
select one
Individual Membership
Family Membership
Contact Information for additional members (optional)
Please fill in names and information for any additional people you wish to associate with this membership. For example: partner(s)/spouse, member of household, or child over the age of 12. There will be space to fill in information about children under 12 below.
Additional Member Name
First Name
Last Name
Relationship to Primary member
*
Example: partner, child (only fill out if over 12), co-parent
I also go by
Pronouns
How do you pronounce your name?
Email
Verify Email
Phone Number
Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Date of Birth
(mm/dd/yyyy)
Additional Member Name
First Name
Last Name
Relationship to Primary Member
Example: partner, child (only fill out if over 12), co-parent
I also go by
Pronouns
Email
Verify Email
Phone Number
Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Date of Birth
(mm/dd/yyyy)
Do you want to opt into our member-to-member discussion listserv?
*
select one
Yes
No
How did you and any additional people associated with this membership learn about this community?
*
Household information
If you are joining as an individual, please share more about who is in your household, in whatever way the term is meaningful to you.
Household / Family
Use this space to describe anyone who you consider to be part of your household, and their relationship to you.
Children
Tell us the names and birth years of any children in your household! Please note that children over the age of 12 are invited to become members themselves, but all children (regardless of age) are welcome to attend and participate along with a guardian or caregiver.
Allergies and food restrictions:
Makom often hosts events with shared meals. Please list the food allergy and how severe it is. For shared memberships and kids' allergies, include the first name of the person with the allergy. Please also include here if you or your household keep Kosher (briefly describe your practice).
Photo release
I give my permission to be photographed or videotaped during program activities. I give permission for Makom to use photo and video content that includes me on website, print, and social media.
select one
Yes
No
Access needs
Please share anything that would make it more possible for you to participate in Makom gatherings and programs. Access is a priority, and while are not currently able to offer all of these resources, we strive to create spaces that are accessible and comfortable for everyone in our community.
Live captions
ASL interpretation
Large print resources
Braille
Sensory sensitive
Scent-free/sensitive
Amplified sound
Ramp and elevator access
Accessible parking
Reserved seating
Masking for outdoor events
Other
Other Access Needs
Please use this space to share any access needs not captured above.
Jewish Practice and Life Cycles
Hebrew names (if any)
Please provide the Hebrew names of anyone associated with this membership.
Conversion anniversary
(mm/dd/yyyy)
Sobriety anniversary
(mm/dd/yyyy)
Faith community affiliations
Do you belong to any other faith communities or congregations, or identify with any other religious or spiritual traditions? If so, we invite you to list them here.
Yahrtzeit
Please share the names and death dates — including year, if known, of loved ones whose anniversary of death you would like to honor in community. This can be biological or chosen family, listed in any order. We will add these names to our community Yahrzeit list which is read before Kaddish is recited at services. Consider sharing as much of the following information as you wish: English Name; Hebrew Name; Their relationship to you; English Date of Death, and if passing was before or after sunset; Hebrew Date of Death
Are you interested in:
How are you interested in getting involved in this community?
Singing, song leading, and music
Shabbat services (help lead, plan, or learn to lead)
High Holiday planning
Plan celebrations for other holidays
Plan community social gatherings
Join the Mutual aid and community care team
Join the Kidz Team
Help with finances (budgeting, bookkeeping)
Help with fundraising
Join the Communications Team
Join the Membership Team
Join the Logistics Team
Community Safety Team
What skills are you interested in sharing with this community?
Art-making
Graphic design
Sewing
Carpentry
Photography
Singing
Playing an instrument
Cooking
Database support
Fundraising & grant writing
Copy editing
Greeting: I am a people person!
Setup and cleanup at events
Childcare
Kids & youth education
Adult education
Event planning
Facilitation
Reading Torah
Demographic information
It’s important that we are grounded in who is represented within our community, and we invite you to share some demographic information with us. All information is optional to share.
Are you or anyone associated with this membership:
Black
Indigenous
A person of color
White
Sephardi / Mizrahi
Ashkenazi
LGBTQIA+
Trans/genderqueer/genderfluid/non-binary
Over 65
Under 25
Chronically ill / disabled
Membership Sustaining Contribution
Please select your sustaining contribution amount and schedule preference. The below amounts are listed in both monthly and yearly installments, but please feel free to enter an amount between this benchmark amounts. For example, if you find yourself at the sliding scale $36/mo amount but prefer to pay one-time, please enter $432 and "yearly." Use this link as a guide: https://docs.google.com/document/d/1U03Voj3Y12DtuKGitiG9JonIUyE2lfIVyQMwOC19Ly0/edit
Dues Amount
*
$0
-
Sliding Scale (starting, monthly)
$10
-
Sliding Scale (high, monthly)
$18
-
True Cost (low-end, monthly)
$72
-
Solidarity Contribution (monthly)
$162
-
Solidarity Contribution (monthly)
$250
-
Solidarity Contribution (monthly)
$120
-
Sliding Scale (high, yearly)
$216
-
True Cost (low-end, yearly)
$864
-
Solidarity Contribution (yearly)
$1,944
-
Solidarity Contribution (yearly)
$3,000
-
Solidarity Contribution (yearly)
$
Donation Schedule
Monthly
Yearly