Membership Option Although we welcome and serve our entire Hewlett community, regardless of membership, we invite you to consider registering as a "member"! Fill out our membership form to connect with our community and start enjoying the benefits of being part of our beautiful family! This optional registration allows you to: - Deepen your connection with our community - Show your support for our mission and programs - Receive updates and insights into our initiatives Be part of the most beautiful "family" in town! Of course, our programs and services remain open to everyone, regardless of membership status but registration allows you to take your involvement to the next level You can download the form by clicking here. If you filled out the form in the past and nothing has changed please let us know. FIRST ADULT HEAD OF HOUSEHOLD Have you filled out this form before?* Click Yes ONLY if your info has not changed. YesNo Full Name* Prefix First Name Last Name Hebrew Name First Name ben/bat Father's Hebrew name Birth Date* Month Day Year E-mail* I am...* Jewish From BirthConvertedNot Jewish Family CohenLeviYisroel Cell Number* Area Code Phone Number Work Number Area Code Phone Number Home Number Area Code Phone Number SECOND ADULT HEAD OF HOUSEHOLD Full Name Prefix First Name Last Name Hebrew Name First Name ben/bat Father's Hebrew name Birth Date Month Day Year E-mail I am... Jewish From BirthConvertedNot Jewish Family CohenLeviYisroel Cell Number Area Code Phone Number Work Number Area Code Phone Number Home Number Area Code Phone Number PERSONAL INFORMATION Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Marital Status* SingleMarriedDivorcedWidowed Wedding Date* Month Day Year CHILDREN Do you have new children to add?* YesNo How many children?* First Child's Full Name* First Name Last Name Hebrew Name Birth Date* Month Day Year Second Child's Full Name* First Name Last Name Hebrew Name Birth Date* Month Day Year Third Child's Full Name* First Name Last Name Hebrew Name Birth Date* Month Day Year Fourth Child's Full Name* First Name Last Name Hebrew Name Birth Date* Month Day Year Fifth Child's Name* First Name Last Name Hebrew Name Birth Date* Month Day Year Sixth Child's Name* First Name Last Name Hebrew Name Birth Date* Month Day Year YAHRZEITS Are there new Yahrzeits you'd like to add?* YesNo How many Yahrzeits?* Full Name* First Name Last Name Hebrew Name First Name ben/bat Father's/Mother's Hebrew Name Date of Death* Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM Time of Death was during the... DayNightI don't know Observer * To whom is the Deceased related? Deceased's relationship to Observer* Full Name* First Name Last Name Hebrew Name First Name ben/bat Father's/Mother's Hebrew Name Date of Death* Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM Time of Death was during the... DayNightI don't know Observer* To whom is the Deceased related? Deceased's relationship to Observer* Full Name* First Name Last Name Hebrew Name First Name ben/bat Father's/Mother's Hebrew Name Date of Death* Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM Time of Death was during the... DayNightI don't know Observer* To whom is the Deceased related? Deceased's relationship to Observer* Full Name* First Name Last Name Hebrew Name First Name ben/bat Father's/Mother's Hebrew Name Date of Death* Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM Time of Death was during the... DayNightI don't know Observer* To whom is the Deceased related? Deceased's relationship to Observer* Comments Please tell us anything else you'd like us to know Optional Donation No fees, just friendship! We don't charge for membership. Instead, we rely on donations to keep our community thriving. If you choose to make a monthly donation of any amount (suggested: $125 monthly) we'll proudly recognize your commitment on our monthly donor board. Membership Donation Options $5000$3600$2500$1800$540$360$180$120$108$75$54$36 Yes, I'd like to make this a monthly recurring payment. Payment Credit Card Paypal ACH, Check, Check or Zelle Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2024202520262027202820292030203120322033 Expiration YearPaypal has been selected. 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