New Members - Chabad of the West Side

Welcome to the Chabad Shul of the West Side
We welcome you to join our membership family and enjoy being part of our wonderful community!

Membership Rates:

$1,350 Family Membership
$600 Single Membership
$360 Associate Membership (does not include High Holiday Seats)
Additional rates are available for students and single parents, please call the office (212-864-5010) for rates.

Membership Benefits:

• 2 Complimentary seats for High Holiday services / 1 Complimentary seat for single membership.
•not included in associate membership
• 50% discount on rental of the synagogue hall for simchas
• Free membership in Shabbat Kids Shul and Junior Congregation
• 10% off all events at Chabad
• Belonging to an amazing Jewish community & building lifelong friendships

Annual membership at Chabad corresponds to the Jewish Year. Your new membership runs from September through August.

We’d love for YOUR FAMILY to become a part of OUR FAMILY!

To renew your existing membership click here.
SECTION I: YOUR INFO
Full Name*
First Name Last Name
Hebrew Name
E-mail*
Cell Number
Occupation
Work Number

Area Code Phone Number
Father's Hebrew Name
Mother's Hebrew Name
Birth Date

Month Day Year
Jewish by:

BirthConverted
Father is a:

KohenLeviIsrael
SECTION II: YOUR SPOUSE'S INFO
Spouse Full Name
First Name Last Name
Spouse Hebrew Name
E-mail
Cell Number
Occupation
Work Number

Area Code Phone Number
Father's Hebrew Name
Mother's Hebrew Name
Birth Date

Month Day Year
Father is a:

KohenLeviIsrael
Jewish by:

BirthConverted
SECTION III: PERSONAL INFORMATION

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone

Area Code Phone Number
Marital Status
Anniversary Date

Month Day Year
SECTION IV: CHILDREN
Name
Birth Date

Month Day Year
Name
Birth Date

Month Day Year
Name
Birth Date

Month Day Year
Name
Birth Date

Month Day Year
Name
Birth Date

Month Day Year
Name
Birth Date

Month Day Year
SECTION V: YAHRZEIT INFORMATION
Name
Date of Passing

Month Day Year
Hebrew Date of Passing
Relationship
Name
Date of Passing

Month Day Year
Hebrew Date of Passing
Relationship
Name
Date of Passing

Month Day Year
Hebrew Date of Passing
Relationship
Name
Date of Passing

Month Day Year
Hebrew Date of Passing
Relationship
Name
Date of Passing

Month Day Year
Hebrew Date of Passing
Relationship
Name
Date of Passing

Month Day Year
Hebrew Date of Passing
Relationship
SECTION VI: HIGH HOLIDAY SEATS RESERVATIONS
Please click here if you'd like to reserve your complimentary High Holiday Seats now.
You can also do so at a later time by visiting the High Holiday Page on our website.
SECTION VII: ANNUAL MEMBERSHIP CONTRIBUTIONS
Please select membership level: Partner

Pillar - $18,000Partner - $10.000Friend - $5,400Level Up- $3,600
Please select membership level: Standard

Family - $1,350Single - $600Associate - $360
Payment Method:*

Please bill meCredit Card - Full PaymentCredit Card - 10 equal monthly payments
Total:

$0.00 USD

I would like to pay today:Full amount10% minimum: $0.00 USD$ USD

Card Details:

Credit Card Please bill me

**All contributions are tax deductible and can be paid throughout the year. No one is turned away due to lack of funds. If you cannot afford the full amount requested, please contact Rabbi Kugel at [email protected] for a confidential arrangement.
Should be Empty:

Welcome to the Chabad Shul of the West Side

SECTION I: YOUR INFO

SECTION II: YOUR SPOUSE'S INFO

SECTION III: PERSONAL INFORMATION

SECTION IV: CHILDREN

SECTION V: YAHRZEIT INFORMATION

SECTION VI: HIGH HOLIDAY SEATS RESERVATIONS

SECTION VII: ANNUAL MEMBERSHIP CONTRIBUTIONS