Shul Membership

Welcome to Chabad Chayil Membership
Thank you for choosing to become a supporting member of Chabad Chayil & The Family Shul. Your membership is more than a donation, it's a partnership in building a vibrant, welcoming Jewish community for everyone.

Thanks to members like you, we're able to offer meaningful holiday celebrations, inspiring classes, youth programs, family events, community support, and a place where every Jew feels at home.

Please take a few moments to complete the form below. This helps us get to know your family, serve you better, and ensure we can keep you informed about the programs and opportunities most meaningful to you.

As a member, you'll also enjoy exclusive member benefits, priority registration for select programs, and the satisfaction of helping strengthen Jewish life in our community.

Welcome to the Chabad Chayil family. We're honored to have you as a partner in our shared mission.
SECTION I: YOUR INFO
Full Name
Prefix First Name Last Name
Jewish Name
Father's Hebrew Name
Mother's Hebrew Name
Occupation
Birth Date

Month Day Year
Jewish By:

BirthConvertedNot Jewish / Ben Noah (that should be by both spouses)
Check One:

CohenLeviIsrael
E-mail
Mobile Number

Area Code Phone Number
SECTION II: SPOUSE'S INFO
Full Name
Prefix First Name Last Name
Phone Number
E-mail
Hebrew Name
Father's Hebrew Name
Mother's Hebrew Name
Occupation
Birth Date

Month Day Year
Jewish By:

BirthConverted
Check One

CohenLeviIsrael
SECTION III: PERSONAL INFORMATION

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Number

Area Code Phone Number
Marital Status
Anniversary Date

Month Day Year
Previous Synagogue & Rabbi
City Married and Officiating Rabbi
If Divorced: Do you have a Jewish "Get"?

YesNo
Add Children

YesNo
SECTION IV: CHILDREN
Name Child 1
Birth Date Child 1

Month Day Year
Name Child 2
Birth Date Child 2

Month Day Year
Name Child 3
Birth Date Child 3

Month Day Year
Name Child 4
Birth Date Child 4

Month Day Year
Name Child 5
Birth Date Child 5

Month Day Year
Name Child 6
Birth Date Child 6

Month Day Year
Are any children adopted?

YesNo
Please give details, including conversion info:
SECTION V: YAHRZEIT INFORMATION
1
English Name
First Name Last Name
Jewish Name
Relation

BenBas
Parent's Hebrew Name
Date of Passing:

Month Day Year
Relationship
2
English Name
First Name Last Name
Jewish Name
Relation

BenBas
Parent's Hebrew Name
Date of Passing:

Month Day Year
Relationship
3
English Name
First Name Last Name
Jewish Name
Relation

BenBas
Parent's Hebrew Name
Date of Passing:

Month Day Year
Relationship
4
English Name
First Name Last Name
Jewish Name
Relation

BenBas
Parent's Hebrew Name
Date of Passing:

Month Day Year
Relationship
5
English Name
First Name Last Name
Jewish Name
Relation

BenBas
Parent's Hebrew Name
Date of Passing:

Month Day Year
Relationship
6
English Name
First Name Last Name
Jewish Name
Relation

BenBas
Parent's Hebrew Name
Date of Passing:

Month Day Year
Relationship
SECTION VI: Please tell us which programs most interest you.
Choose all that apply:

Shabbat ServicesHoliday ServicesHigh HolidaysSunday MinyanDaily MinyanAdult EducationHebrew SchoolChildren's ProgramsBar/Bat MitzvahWomen's CircleJewish Business NetworkCommunity ServiceOtherJoin a Committee
SECTION VII: GENERAL QUESTIONS
How did you find out about us?
Did you belong to any Shul before this?
Are you affiliated with any other Jewish organization?
Notes:
SECTION VIII: MEMBERSHIP PLAN
Community Member

$1212$101 Per Month
Community Friend If you're not yet ready to become a member

$648$54 Per Month
I'm going through a financial struggle. I'll pay: I'll try to support the community in other ways.

OnceMonthly
Specify Amount One Time Payment
Specify Amount Monthly Payment
Other ways I can help the community
Section IX: Optional Partnership
Builder Partner Helps support Jewish programming throughout the year.

$180/month ($2,160 per year)
Community Partner Helps strengthen holiday programs and community events

$360/month ($4,320 per year)
Leadership Partner Helps expand educational and outreach initiatives.

$540/month ($6,480 per year)
Visionary Partner Helps sustain major community growth and impact.

$1,000/month ($12,000 per year)
Legacy Partner Provides transformational support for Chabad's mission.

$1,800/month ($21,600 per year)
Founder Partner Provides foundational support for the future of our community.

$4,500/month ($54,000 per year)
All partners receive recognition on the Chai Club Wall according to their partnership level.
Section X: Payment Information
Total

$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

Should be Empty:

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Welcome to Chabad Chayil Membership

SECTION I: YOUR INFO

SECTION II: SPOUSE'S INFO

SECTION III: PERSONAL INFORMATION

SECTION IV: CHILDREN

SECTION V: YAHRZEIT INFORMATION

1

2

3

4

5

6

SECTION VI: Please tell us which programs most interest you.

SECTION VII: GENERAL QUESTIONS

SECTION VIII: MEMBERSHIP PLAN

Section IX: Optional Partnership

All partners receive recognition on the Chai Club Wall according to their partnership level.

Section X: Payment Information