Lori Schottenstein Chabad Center for a Jewish Tomorrow -
Membership Form 5771

Last Name  

Principal Members

        am pm
Name                                   Jewish name                         Birthdate

    
Mother's Jewish name            Father's Jewish name

        am pm
Name                                   Jewish name                         Birthdate

    
Mother's Jewish name            Father's Jewish name

Children

        am pm
Name                                    Jewish name                        Birthdate

        am pm
Name                                    Jewish name                        Birthdate

        am pm
Name                                    Jewish name                        Birthdate

        am pm
Name                                    Jewish name                        Birthdate

Contact Details

Home Address

Work Address

      
Home phone               

        
Cell phone                 Name

    
Work phone              Name

Email

Yartzeits

        
Jewish names                        Date                        Relationship

        
Jewish names                        Date                        Relationship

        
Jewish names                        Date                        Relationship

        
Jewish names                        Date                        Relationship

Preferences

I/we are interested in the following:

Attending weekly classes 

Lifetown

Youth Programs

Shabbat Morning Minyan  

Rosh Chodesh Club (women)  

Jewish Business Network

Hebrew School  
Other - Please specify:

Payments

I am submitting payment for:

Family Membership $500    Single Membership $350   Enhanced Membership $750

Annually: 1 payment due Oct. 1    Semi-annually: 2 payments due Oct. 1 & Jan. 1

Please make a note in the "I WOULD LIKE MY DONATION TO BE USED FOR" box that this is a membership payment. Thank you.

Membership includes: 

• Services of the Rabbi at all life cycle events.
• Bar/Bat Mitzvah facilitation.
• Discounted Chabad Hebrew School tuition
• 30% discount on facility rental fees
• Weekly e-newsletter and other communications

Enhanced Membership:
• All features of Membership
• Kiddush for one occasion of your choice. (Please call the office to reserve your special date).

Hebrew School Tuition
• Members: $625
• Non-members: $775

Kiddush sponsorship
$350