B'nai Shalom, Children of Peace, Org Membership Application

Jewish Mormons, Mormons with Jewish Lineage, Mormons with Jewish in Family, Interested Friends all welcome.
No Membership fee, No Obligation. Gatherings twice a year, and email news/Shofar newsletters

Please open and read the Mission Statement, which your applying implies that you have read and support. We are not part of the Church, but we support Church leaders and policies. Further Explanation

Note: We need the info below because: (1) We need to know what region you are in; we plan to form committees. (2) If emails change we can call you to get an update. This data is private, not provided to anyone else.

Please make name and address entries Upper-Lower case, not all UPPER.
First Name: *

Last Name: *

City: *
Two digit STATE + ZIP (or Province + Code)
PLEASE don't skip the state *

Country: (Change if not USA)
Home Phone: (Leave blank if you only have a cellphone)

Cell Phone: *

Email Address: *

Alternate Email (Only if you have an additional address)

Please enter only personal email address, such as gmail, hotmail, msn, yahoo. Not corporate, government, or LDS/BYU.
Interest (Control-click ANY that apply)
ANY Optional Comment, etc.
1) This Organization has no affiliation with the Church, does not represent the Church, receives no support from the Church, is not sanctioned by the Church in any way; therefore, its actions cannot be attributed to the Church.
2) No Officer, Director, or member shall proselytize or act in any way that may be construed as having the purpose of proselytizing of descendants of Abraham in the State of Israel.
Your applying implies that you agree to support the B'nai Shalom Mission Statement.