Printed from KansasJewish.com

Where Judaism comes alive

Membership

ADULT MALE
Full Name
First NameLast NameHebrew Name
Parent's Hebrew Name
Father'sMother's
Birth Date
MonthDayYear
E-mail
Occupation
Jewish
From BirthConvertNot Jewish
Family
KohenLeviYisroel
Cell Number
Area CodePhone Number
Work Number
Area CodePhone Number
Home Number
Area CodePhone Number
ADULT FEMALE
Full Name
First NameHebrew NameHebrew Name
Parent's Hebrew Name
Father'sMother's
Birth Date
MonthDayYear
E-mail
Occupation
Jewish
From BirthConvertNot Jewish
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 NameHebrew Name
Birth Date
MonthDayYear
Full Name
First NameLast NameHebrew Name
Birth Date
MonthDayYear
Full Name
First NameLast NameHebrew Name
Birth Date
MonthDayYear
Full Name
First NameLast NameHebrew Name
Birth Date
MonthDayYear
Membership Plan
Please choose one of the following.
Annual
$770 Regular Membership$360 Young Family Membership$360 Senior Membership
Semi-Annual
$385 Regular Membership$180 Young Family Membership$180 Senior Membership
10 Month Option
$77 Regular Membership$36 Young Family Membership$36 Senior Membership
I would like to make an additional donation to help support The Shul - Chabad of Leawood.
$180 Monthly$72 Monthly$36 Monthly$100 Monthly$54 Monthly$18 Monthly
Are there any programs or services that you would like to see Chabad provide? Please list below.
Other Services
I wish to purchase a Lulav & Etrog set for the holiday of Sukkot (cost $60)I wish to receive additional info on Chabad Hebrew SchoolI wish to receive additional info on Gan Chabad PrechoolI wish to receive additional info on Adult Education classesI wish to receive additional info on Jewish Women's programsI wish to receive Chabad's weekly Parsha thought to my E-mail

Payment

Credit Card Other

Postal / Zip Code

Country

Should be Empty:

This page uses TLS encryption to keep your data secure.