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Where Judaism comes alive

Membership

Chabad of the Main Line Membership & Partnership form
High Holiday Seats included with Membership

Chabad reaches out and welcomes every Jew who seeks to learn, pray, participate or be helped. There is no membership requirement to cross our threshold and be involved in our many activities. There are some people, however, that wish to show their support and affiliation with a formal membership.
ADULT MALE
Full Name
First NameLast Name
Hebrew Name
Birth Date
MonthDayYear
E-mail
Occupation
Jewish by
BirthConverted
Family
KohenLeviYisroel
Cell Number
Area CodePhone Number
Work Number
Area CodePhone Number
Home Number
Area CodePhone Number
ADULT FEMALE
Full Name
First NameLast Name
Hebrew Name
Birth Date
MonthDayYear
E-mail
Occupation
Jewish by
BirthConverted
Family
KohenLeviYisroel
Cell Number
Area CodePhone Number
Work Number
Area CodePhone Number
Home Number
Area CodePhone Number
PERSONAL INFORMATION

Address

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

Marital Status
Anniversary Date
MonthDayYear
CHILDREN
Full Name
First NameLast Name
Birth Date
MonthDayYear
Full Name
First NameLast Name
Birth Date
MonthDayYear
Full Name
First NameLast Name
Birth Date
MonthDayYear
Full Name
First NameLast Name
Birth Date
MonthDayYear
Membership Plan
Please choose your membership option.

MEMBERSHIP TYPE	ANNUAL	BI-ANNUAL	QUARTERLY


Family (Head of household 30 or older)	$1,000.00	$500.00	$250.00
Single, Young Family, Single Parent, Senior* (Head of household under 30, *Senior 65 or older)	$770.00	$385.00	$192.50
Associate Membership (offered without respect to age)	$540.00	$270.00	$135.00

Membership Options
$1000 Family$770 Single, Young Family, Single Parent, Senior$540 Associate Membership
Payment Options
FullBi-AnnualQuarterly
Bi-Annual & Quarterly payments are made with post-dated checks or a credit card. All checks and charges must be given and authorized at one time. Checks will be processed on the date written on the check. Credit cards will be charged on the first business day of your selected payment schedule.
Partners to Chabad
Chabad of the Main Line needs your generous support for our facility and activities. In addition to your membership, please consider joining "Partners of Chabad." Below are suggested levels of annual support. Thank you!
Partnership Options
$360$500$613$1000$1800$3600
Bill me
AnnuallyBi-AnnuallyQuarterlyMonthly
Payment
Total
$0.00

I would like to pay today: Full amount$0.00 minimum $
Comments/Questions

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Country

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