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Membership

Membership

The Chabad of Weston Family
We are diverse group of people from various level  of  observance who came together for learning, spiritual growth, social interaction and friendship. We invite you to join our growing family and become part of this wonderful community.
Join Chabad today! 

**If you prefer to download your form and send it in the mail please click here. 

 

SECTION I:  YOUR INFO

SECTION II:  SPOUSE'S INFO

 Name

 

 Name

 Hebrew Name    Hebrew Name
 Father's Hebrew 
 Name
   Father's Hebrew 
 Name
 Mother's Hebrew
 Name
   Mother's Hebrew
 Name
 Occupation    Occupation
 Birth Date /  /
MM / DD / YYYY format
   Birth Date /  /
MM / DD / YYYY format
 Jewish by:   Birth    Converted    Jewish by:   Birth     Converted
 Check One:   Cohen   Levi   Israel    Check One:   Cohen   Levi   Israel

SECTION III:  PERSONAL INFORMATION

Address   Email 1
 City/State/Zip   Email 2
 Home Phone   Marital Status
 Work Phone   Anniversary Date /  /
MM / DD / YYYY format
 Work Fax   If Divorced: If divorced, do you have a
Jewish "Get" ?  Yes  No

SECTION IV: CHILDREN

 Name

 

 Birth Date

/  /
MM / DD / YYYY format

 Name

 

 Birth Date

/  /
MM / DD / YYYY format

 Name

 

 Birth Date

/  /
MM / DD / YYYY format

 Name

 

 Birth Date

/  /
MM / DD / YYYY format

 Name

 

 Birth Date

/  /
MM / DD / YYYY format

 Name

 

 Birth Date

/  /
MM / DD / YYYY format
 Are any children adopted?  Yes   No    If yes, give details, including any coversion info:
 

SECTION V: YAHRZEIT INFORMATION

 Name


English / Hebrew / Father's Hebrew / Last

 

/  /
Date of Passing: MM / DD / YYYY
Relationship

 Name


English / Hebrew / Father's Hebrew / Last

 

/  /
Date of Passing: MM / DD / YYYY
Relationship

 Name


English / Hebrew / Father's Hebrew / Last

 

/  /
Date of Passing: MM / DD / YYYY
Relationship

 Name


English / Hebrew / Father's Hebrew / Last

 

/  /
Date of Passing: MM / DD / YYYY
Relationship

 Name


English / Hebrew / Father's Hebrew / Last

 

/  /
Date of Passing: MM / DD / YYYY
Relationship

 Name


English / Hebrew / Father's Hebrew / Last

 

/  /
Date of Passing: MM / DD / YYYY
Relationship

SECTION VI: MEMBERSHIP CONTRIBUTIONS - ANNUAL
Family: $1,350  Single: $825 

Senior Citizen (Over 65) $825 ~ Seasonal $525*

Payment Options:

One full payment of:

 

 Please chage my:

 Visa   M/C   AMEX
  Quarterly payments, each    Card #:
  Monthly payments of each    Exp. Date

Payment Method:

 Credit Card
 Check is in the mail
 Please bill me
 
  Optional Comments:

* 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, contact the Rabbi for a confidential arrangement.

Press "Continue" below to continue to PayPal to make a payment.

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