Renew Membership - Chabad of the West Side

Thank you for choosing to renew your membership for the Hebrew year 578 (2026-2027)!

As a reminder, here are the current membership rates and benefits.

$1,350 Family Membership
$600 Single Membership
$360 Associate Membership (does not include High Holiday Seats)

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
Please select one:*

If all of your info remains the same and you'd just like to renew, please select this optionIf you'd like to update any of your membership information please select this option and fill out the required and desired fields below
SECTION I: YOUR INFO
Full Name*
First Name Last Name
Hebrew Name
E-mail*
Cell Number

Area Code Phone 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

Area Code Phone 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
If divorced, do you have a Jewish "get"?

YesNo
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: ANNUAL MEMBERSHIP CONTRIBUTIONS
Please select membership level: Standard

Family - $1,350Single - $600Associate - $360
Please select membership level: Partner

Pillar - $18,000Partner - $10.000Friend - $5,400Level Up- $3,600
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.
SECTION VII: HIGH HOLIDAY SEATS RESERVATIONS
Please click here if you'd like to open a new tab to reserve your complimentary High Holiday Seats now. Remember to return to this tab to press SUBMIT for this form.
You can also do so at a later time by visiting the High Holiday Page on our website.
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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

SECTION VII: HIGH HOLIDAY SEATS RESERVATIONS