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Shul Membership

Chabad of the West Side Shul Membership
We welcome you to join our membership family and enjoy being part of our wonderful community!
Annual membership at Chabad corresponds to the Jewish Year. Membership should be renewed every year during August.
Membership Rates:
$1,320 Family Membership
$600 Single Membership
$360 Associate Membership (does not include High Holiday Seats)
$180 Alumni Membership
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
• 50% discount on rental of the synagogue hall for simchas
• Free membership in Kids Shul and Junior Congregation
• Belonging to an amazing Jewish community & building lifelong friendships

We’d love for YOUR FAMILY to become a part of OUR FAMILY!
Please select one:*
I would like to renew my membership. All my information remains the same. (Fill in the REQUIRED* text fields on the form below and go to section 6 for payment)I would like to renew my membership. Please note the changes to my information below. (Fill in the REQUIRED* text fields and other updated fields on the form below and go to section 6 for payment)I would like to become a member (Fill in all sections as applicable and go to section 6 for payment)
SECTION I: YOUR INFO
Full Name*
First NameLast Name
Hebrew Name
E-mail*
Cell Number
Area CodePhone Number
Occupation
Work Number
Area CodePhone Number
Father's Hebrew Name
Mother's Hebrew Name
Birth Date
MonthDayYear
Jewish by:
BirthConverted
Father is a:
KohenLeviIsrael
SECTION II: YOUR SPOUSE'S INFO
Spouse Full Name
First NameLast Name
Spouse Hebrew Name
E-mail
Cell Number
Area CodePhone Number
Occupation
Work Number
Area CodePhone Number
Father's Hebrew Name
Mother's Hebrew Name
Birth Date
MonthDayYear
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 CodePhone Number
Marital Status
Anniversary Date
MonthDayYear
If divorced, do you have a Jewish "get"?
YesNo
SECTION IV: CHILDREN
Name
Birth Date
MonthDayYear
Name
Birth Date
MonthDayYear
Name
Birth Date
MonthDayYear
Name
Birth Date
MonthDayYear
Name
Birth Date
MonthDayYear
Name
Birth Date
MonthDayYear
SECTION V: YAHRZEIT INFORMATION
Name
Date of Passing
MonthDayYear
Relationship
Name
Date of Passing
MonthDayYear
Relationship
Name
Date of Passing
MonthDayYear
Relationship
Name
Date of Passing
MonthDayYear
Relationship
Name
Date of Passing
MonthDayYear
Relationship
Name
Date of Passing
MonthDayYear
Relationship
SECTION VI: ANNUAL MEMBERSHIP CONTRIBUTIONS
Please select membership level:*
Family - $1,320Single - $600Associate - $360Kids Shul - $360Alumni - $180
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 for lack of funds. If you cannot afford the full amount requested, please contact Rabbi Kugel at rsk@chabadwestside.org for a confidential arrangement.
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Chabad of the West Side Shul Membership

SECTION I: YOUR INFO

SECTION II: YOUR SPOUSE'S INFO

SECTION III: PERSONAL INFORMATION

SECTION IV: CHILDREN

SECTION V: YAHRZEIT INFORMATION

SECTION VI: ANNUAL MEMBERSHIP CONTRIBUTIONS