New Membership Option Chabad House of Hewlett is a Non-Profit Community Organization that serves the entire Jewish community of Greater Hewlett with love and affection. We look to care for any and every Jew regardless of background, affiliation, age or level of observance. In addition to many social and community events, our Chabad house is offering the full-range of support and resources to the community that you have come to expect from a synagogue. Many people, who have already joined our services and programs, still ask, "Can I become a ‘member’ ? Can I ‘officially’ join so that my kids have a place they can refer to as ‘ my temple ’? Can I be ‘affiliated’ so that I can continue the feeling of belonging that my parents and their parents felt as ‘temple members’ for so many years?" Now, we are happy to say, the answer is, YES! By filling out this form, you will officially become a member of Chabad of Hewlett Jewish Center. 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 Birth Converted Not Jewish Family Cohen Levi Yisroel Cell Number* Area Code Phone Number Work Number Area Code Phone Number Home Number Area Code Phone Number 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 Birth Converted Not Jewish Family Cohen Levi Yisroel 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 Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Marital Status Single Married Divorced Widowed Wedding Date Month Day Year CHILDREN First Child's Full Name First Name Last Name Hebrew Name First Name ben/bat Father's Hebrew name Birth Date Month Day Year Second Child's Full Name First Name Last Name Hebrew Name First Name ben/bat Father's Hebrew Name Birth Date Month Day Year Third Child's Full Name First Name Last Name Hebrew Name First Name ben/bat Father's Hebrew Name Birth Date Month Day Year Fourth Child's Full Name First Name Last Name Hebrew Name First Name ben/bat Father's Hebrew Name Birth Date Month Day Year YAHRZEITS Full Name First Name Last Name Hebrew Name First Name ben/bat Father's Hebrew Name Date of Death Month Day Year Time of Death was during the... day or night 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 Hebrew Name Date of Death Month Day Year Time of Death was during the... day or night 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 Hebrew Name Date of Death Month Day Year Time of Death was during the... day or night 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 Hebrew Name Date of Death Month Day Year Time of Death was during the... day or night Observer To whom is the Deceased related? Deceased's relationship to Observer Optional Donation Chabad of Hewlett does not require dues for membership. Please consider making a donation to Chabad of Hewlett in honor of becoming a member. Please keep in mind that the average cost for membership in the Greater Hewlett area is $1500. Make it a monthly Partnership and your name will appear on our Donor board. Thank you for your continued support! 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 Cash or Check Credit Card Visa MasterCard American Express Discover Credit Card Type Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 Expiration Year Total $0.00 Yes, I'd like to donate the cost of processing this transaction by adding 3% I would like to receive news and updates by email Submit Should be Empty: This page uses TLS encryption to keep your data secure.
This page uses TLS encryption to keep your data secure.
This page uses TLS encryption to keep your data secure.
This page uses TLS encryption to keep your data secure.