Chabad Membership 2024

Chabad Membership 2024 - 2025

Hebrew Calendar Year 5785
I am a new memberI am a returning member
Your Information
Name*

First NameLast Name
Hebrew Name*
Fathers Hebrew Name*
Mothers Hebrew Name*
Birth Date*

MonthDayYear
Date
I am a*

CohenLeviIsrael
Cell Phone Number*
Please enter a valid phone number.
Please add me to Chabad's Whatsapp broadcast to get schedules of services, upcoming events and updates.

Yes
Email*
example@example.com
Marital Status*

SingleMarriedDivorced
Spouses Information
Name*

First NameLast Name
Hebrew Name*
Fathers Hebrew Name*
Mothers Hebrew Name*
Birth Date*

MonthDayYear
Date
I am a*

CohenLeviIsrael
Cell Phone Number*
Please enter a valid phone number.
Please add me to Chabad's Whatsapp broadcast to get schedules of services, upcoming events and updates.

Yes
Email*
example@example.com
Personal Information
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Anniversary Date*

MonthDayYear
Date
Divorce Date*

MonthDayYear
Date
Who was the Get Administered By?*
Children
Number of Children*
Child #1
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #2
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #3
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #4
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #5
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #6
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #7
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #8
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #9
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #10
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #11
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Child #12
Name*
Hebrew Name*
Date*

MonthDayYear
Date
Born in*

NightDay
School*
Family Yartzeits
Name*

First NameLast Name
Date of Passing*

MonthDayYear
Date
Relationship*
Name*

First NameLast Name
Date of Passing*

MonthDayYear
Date
Relationship*
Name*

First NameLast Name
Date of Passing*

MonthDayYear
Date
Relationship*
Name*

First NameLast Name
Date of Passing*

MonthDayYear
Date
Relationship*
If you have any additional yartzeits please list them here:
Calendar

Chabad members birthdays are included COMPLIMENTARY in the Calendar! If you would like your family members birthdays included please list the names & birthdays as you would like them to appear in the calendar. Deadline to be included is Thursday, July 13.
Please list my families birthdays & yartzeits in the 2023 - 2024 calendar

YesNo
Two High Holiday seats & priority seat reservation
Family birthdays listed in the annual Chabad calendar
Listing of departed loved ones in Yizkor Booklet
25% discount on Hebrew School
Discounted Bar/Bat Mitzvah fees (after 1st year of membership – must be enrolled in our Hebrew School)
5% discount on Gan Chamesh Preschool 2024 - 2025
10% discount on most events and programs
Mezuzah gift for college age children
Life Cycle event services
Meals delivered for new babies and shiva
Belonging to an amazing Jewish community & building lifelong friendships

Annual Dues Schedule:
$1,440 Family Membership
$1,000 Associated Membership
$900 Single Membership
Payment plans available via credit card, check, cash
Payment*

I would like to pay with Credit CardI would like to pay cash / checkI will call the office to set up a monthly payment plan - 516-295-2478 or email Chabad@Chabadfivetowns.com
New Members receive a 25% discount for the first year!

Use code: Member5785 at checkout to receive this discount

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Chabad Membership 2024 - 2025

Your Information

Spouses Information

Personal Information

Children

Child #1

Child #2

Child #3

Child #4

Child #5

Child #6

Child #7

Child #8

Child #9

Child #10

Child #11

Child #12

Family Yartzeits

Calendar