Step 1: Inquiry Form
Thank you for your interest in Adat Shalom!
This is a new member inquiry form. If you have any questions or require assistance, please call 301-767-3333 or email info@adatshalom.net
Name
*
Email
*
Mobile Phone
*
How did you find out about Adat Shalom?
*
Where do you live?
*
Please select one option.
Silver Spring/Wheaton
Chevy Chase/NW DC
Bethesda
North Bethesda/Rockville
Potomac/Gaithersburg
NoVa
PG County
Other
Select Option
Silver Spring/Wheaton
Chevy Chase/NW DC
Bethesda
North Bethesda/Rockville
Potomac/Gaithersburg
NoVa
PG County
Other
Are you interested in Adat Shalom for:
*
Please select one option.
Yourself Only
Yourself and another Adult
Family with children living at home
Someone else
Select Option
Yourself Only
Yourself and another Adult
Family with children living at home
Someone else
If you are interested in something other than membership, please explain.
Would you like to receive our e-newsletter, HaShavua (the weekly), with information about our upcoming programs?
Please select one option.
Yes, please add me to the mailing list
No thanks
Would you like to be connected with Rabbi Scott?
Please select one option.
Yes, I'd like a message from Rabbi Scott
No thanks
Submit
Description
Thank you for your interest in Adat Shalom!
This is a new member inquiry form. If you have any questions or require assistance, please call 301-767-3333 or email info@adatshalom.net
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