Mosaic Law Congregation Membership Application

Please complete this form and click Submit. A member of the Membership Committee will be in touch with you soon. Your first six months' membership dues is free; however, we do ask that you pay our annual security fee of $180.
If you would prefer to complete your membership information on a paper membership form, click here to download it.

Primary Applicant

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Jewish background 1
Jewish background 2
Have you belonged to MLC previously?

Please provide the name of a friend or relative, not living with you, who we can contact in an emergency if you or your co-applicant are not available.

Secondary Applicant

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Jewish background 1
Jewish background 2
Have you belonged to MLC previously?

Please list children living in the household

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arrow&v
arrow&v
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Mosaic Law Congregation Membership Application

Please complete this form and click Submit. A member of the Membership Committee will be in touch with you soon.

Your first six months' membership dues is free; however, we do ask that you pay our annual security fee of $180.
If you would prefer to complete your membership information on a paper membership form, click here to download it.

Primary Applicant

arrow&v
Jewish background 1
Jewish background 2
Have you belonged to MLC previously?

Please provide the name of a friend or relative, not living with you, who we can contact in an emergency if you or your co-applicant are not available.

Secondary Applicant

Secondary Applicant can be a spouse, significant other, or domestic partner

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Jewish background 1 (2)
Jewish background 2 (2)
Have you belonged to MLC previously? (2)

Please list children living in the household or away at school

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arrow&v
arrow&v
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Thank you! We’ll be in touch soon.