Membership Application

Stars of David International, Inc.
A Jewish Adoption Information & Support Network
Building Jewish Families Through Adoption™

Stars of David
Membership Information Form

Instructions (scroll down to reveal the form)

For everyone:

Complete the form.
Print out the form (see detailed instructions at the bottom of the form),

After completing the form and clicking NEXT you will be brought to the payment
Options page. You will choose your method of payment at this time.

For everyone:

If payment was made online, after the transaction is complete, we will send you (by email if you entered an email address) a member username and password to access the member's only area on the Stars of David web site. (This may take up to 72 hours by email.) For those mailing checks, we will send you r access codes once the checks have cleared.

*Note: Members outside of the United States will incur additional fees based upon higher postage and shipping costs.
Please contact us for the correct fee BEFORE you submit your completed form and payment.

Online Authorize Membership Form

Membership for a New Renewing Member.

This is a gift membership. Yes No If yes, who it is for?

Please choose one of the following Membership options:

Additional donation to help support the programs and outreach programs of
Stars of David

Other amount (if you chose other above)

Member Information (Ship To Address for Membership Kit)
About yourself / member. If organization, identify the primary contact person.

First Name

Last Name

Address 1

Address 2

City

State/Province
Add Country if not U.S. or Canada

Zip/Postal Code

Country

Phone
Please include Area Code

Fax

E-mail

Web-site URL

Chapter Affiliation

Billing Contact Information (Bill To or CreditCard Address)
Even if nformation is same as for Member Information above, please enter it as it is on the CC or Check for payment processing.
(you may skip this as of 5/15/06)

First Name

Last Name

Address 1

Address 2

City

State/Province
Add Country if not U.S. or Canada

Zip/Postal Code

Country

Phone
Please include Area Code

Fax

E-mail

Describing Yourself / Member
To help our network of members and serve your needs, please respond to the items below.

Please describe yourself
If you are an individual/family, please
describe your role(s) and your interests.
If you are agency/organization/professional, please
describe your role(s) and your target audience and/or mission.

To select multiple items, press <Ctrl> and click each item

.

Other - explain here

If you selected an Agency / Professional membership, please describe the organization.

Other - explain here

Name of the Organization
Add description if needed

If you selected an Individual / Family membership, please tell us about the resource(s) you used or are using to complete an adoption.

To select multiple items, press <Ctrl> and click each item.

Adoption Resource Name / Location
Please tell us about the agency or other resources you used / are using for adoption(s)

Staying in Touch
Please tell us how you want us to communicate with you and keep you informed.

Please subscribe the member email address above to the members' LISTSERV (more information) Yes
No

Preferred method to receive members' quarterly newsletter, "Star Tracks" (more information) Electronic (PDF format) downloadable
Standard mail delivery

About your children (if any).
If you need more room, please add the information in the More about us field below.

If your child is at least 9 years old, he or she may join a LISTSERV for members' children.
Check here for more information or to subscribe your child(ren) - will be activated when membership is received.

Name

Year Born

How joined family

Sex

Country of birth

Birth Male

Adoption Female

Birth Male

Adoption Female

Birth Male

Adoption Female

Birth Male

Adoption Female

Birth Male

Adoption Female

More about you
Use the space below to provide other information about your family (e.g., additional child(ren), special needs child(ren), single parent, interfaith family, etc.) you would like to share so we can serve you better.

Information Privacy
Please tell us whether we may share information about you with other members. Stars of David will only reveal statistical information (no identifying information) about any member to any non-member or other organization.

This information may be published on our members list in our members-only web site area.

Yes
No
Some, not all (contact me for clarification)
Contact Member (for gift memberships)

This information may be shared with a member who contacts Stars of David staff seeking to network with other members.
Yes
No
Contact me first
Contact Member (for gift memberships)

Other (please explain)

How did you learn about Stars of David?
So that we reach people interested in joining and participating in Stars of David International, please tell us below how you heard about us.

Questions or comments

Member Information (Ship To Address for Membership Kit) About yourself / member. If organization, identify the primary contact person.
First Name
Last Name
Address 1
Address 2
City
State/Province Add Country if not U.S. or Canada
Zip/Postal Code
Country
Phone Please include Area Code
Fax
E-mail
Web-site URL
Chapter Affiliation

Billing Contact Information (Bill To or CreditCard Address) Even if nformation is same as for Member Information above, please enter it as it is on the CC or Check for payment processing. (you may skip this as of 5/15/06)
First Name
Last Name
Address 1
Address 2
City
State/Province Add Country if not U.S. or Canada
Zip/Postal Code
Country
Phone Please include Area Code
Fax
E-mail

Choose File > PRINT from your browser menu.
Then click OK. Keep these copies for your records.

Click to submit this form. Payment choices of (check, credit card, Paypal) will be made on the next screen.

If you need to start over:

Press to reset form and start again.

Stars of David
Membership Information Form

Instructions (scroll down to reveal the form)

Online Authorize Membership Form

Member Information (Ship To Address for Membership Kit)
About yourself / member. If organization, identify the primary contact person.

Billing Contact Information (Bill To or CreditCard Address)
Even if nformation is same as for Member Information above, please enter it as it is on the CC or Check for payment processing.
(you may skip this as of 5/15/06)

Describing Yourself / Member
To help our network of members and serve your needs, please respond to the items below.

Staying in Touch
Please tell us how you want us to communicate with you and keep you informed.

About your children (if any).
If you need more room, please add the information in the More about us field below.

More about you
Use the space below to provide other information about your family (e.g., additional child(ren), special needs child(ren), single parent, interfaith family, etc.) you would like to share so we can serve you better.

Information Privacy
Please tell us whether we may share information about you with other members. Stars of David will only reveal statistical information (no identifying information) about any member to any non-member or other organization.

How did you learn about Stars of David?
So that we reach people interested in joining and participating in Stars of David International, please tell us below how you heard about us.

Questions or comments

Describing Yourself / Member To help our network of members and serve your needs, please respond to the items below.
Please describe yourself If you are an individual/family, please describe your role(s) and your interests. If you are agency/organization/professional, please describe your role(s) and your target audience and/or mission. To select multiple items, press <Ctrl> and click each item .	Other - explain here
If you selected an Agency / Professional membership, please describe the organization.	Other - explain here
Name of the Organization Add description if needed
If you selected an Individual / Family membership, please tell us about the resource(s) you used or are using to complete an adoption. To select multiple items, press <Ctrl> and click each item.
Adoption Resource Name / Location Please tell us about the agency or other resources you used / are using for adoption(s)

Staying in Touch Please tell us how you want us to communicate with you and keep you informed.
Please subscribe the member email address above to the members' LISTSERV (more information)	Yes No
Preferred method to receive members' quarterly newsletter, "Star Tracks" (more information)	Electronic (PDF format) downloadable Standard mail delivery

About your children (if any). If you need more room, please add the information in the More about us field below.
If your child is at least 9 years old, he or she may join a LISTSERV for members' children. Check here for more information or to subscribe your child(ren) - will be activated when membership is received.
Name	Year Born	How joined family	Sex	Country of birth
		Birth	Male
		Adoption	Female
		Birth	Male
		Adoption	Female
		Birth	Male
		Adoption	Female
		Birth	Male
		Adoption	Female
		Birth	Male
		Adoption	Female

Information Privacy Please tell us whether we may share information about you with other members. Stars of David will only reveal statistical information (no identifying information) about any member to any non-member or other organization.
This information may be published on our members list in our members-only web site area.	Yes No Some, not all (contact me for clarification) Contact Member (for gift memberships)
This information may be shared with a member who contacts Stars of David staff seeking to network with other members.	Yes No Contact me first Contact Member (for gift memberships)
Other (please explain)

Stars of David Membership Information Form

Instructions (scroll down to reveal the form)

Online Authorize Membership Form

Member Information (Ship To Address for Membership Kit) About yourself / member. If organization, identify the primary contact person.

Billing Contact Information (Bill To or CreditCard Address) Even if nformation is same as for Member Information above, please enter it as it is on the CC or Check for payment processing. (you may skip this as of 5/15/06)

Describing Yourself / Member To help our network of members and serve your needs, please respond to the items below.

Staying in Touch Please tell us how you want us to communicate with you and keep you informed.

About your children (if any). If you need more room, please add the information in the More about us field below.

More about you Use the space below to provide other information about your family (e.g., additional child(ren), special needs child(ren), single parent, interfaith family, etc.) you would like to share so we can serve you better.

Information Privacy Please tell us whether we may share information about you with other members. Stars of David will only reveal statistical information (no identifying information) about any member to any non-member or other organization.

How did you learn about Stars of David? So that we reach people interested in joining and participating in Stars of David International, please tell us below how you heard about us.

Questions or comments

Stars of David
Membership Information Form

Member Information (Ship To Address for Membership Kit)
About yourself / member. If organization, identify the primary contact person.

Billing Contact Information (Bill To or CreditCard Address)
Even if nformation is same as for Member Information above, please enter it as it is on the CC or Check for payment processing.
(you may skip this as of 5/15/06)

Describing Yourself / Member
To help our network of members and serve your needs, please respond to the items below.

Staying in Touch
Please tell us how you want us to communicate with you and keep you informed.

About your children (if any).
If you need more room, please add the information in the More about us field below.

More about you
Use the space below to provide other information about your family (e.g., additional child(ren), special needs child(ren), single parent, interfaith family, etc.) you would like to share so we can serve you better.

Information Privacy
Please tell us whether we may share information about you with other members. Stars of David will only reveal statistical information (no identifying information) about any member to any non-member or other organization.

How did you learn about Stars of David?
So that we reach people interested in joining and participating in Stars of David International, please tell us below how you heard about us.