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

State/Province

ZIP/Postal Code

Country

Date of Birth *

(mm/dd/yyyy)

Pronouns (ex. she/her; they/them)

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?

Verify Email

Phone Number

Address

Address Line 1

Address Line 2

City

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

Verify Email

Phone Number

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Date of Birth

(mm/dd/yyyy)

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).

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

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.

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