Membership

Chabad of Irvine Membership

We welcome you to join our membership family and enjoy being part of our wonderful community!

Membership rates:

$1800 Chai Membership: $150 per month
$900 Senior/ Young Families Membership: $75 per month

Membership Benefits:
- 2 Complimentary seats for High Holiday services
- Discount on Preschool tuition
- Discount on Hebrew School tuition
- Discount on all Chabad events and programs including Shabbat Dinners, Passover Seders, JLI, and Lectures
- Belonging to amazing Jewish community & building lifelong friendships
Payment Options:

Choose to make your payment by check or credit card. You may also divide the dues into 12 separate post dated checks or credit card payments throughout the year. You may also choose to have us bill you periodically throughout the year.

We’d love for YOUR FAMILY to become a part of OUR FAMILY!
PERSONAL INFORMATION - Member
Full Name*
First Name Last Name
Occupation
Work E-mail
Personal E-mail*
Cell Phone Number*

Area Code Phone Number

Address*

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

Hebrew Name
Ben (Father’s Hebrew Name)
Ben (Mother’s Hebrew Name)
Birth Date

Month Day Year
Jewish by?

BirthConverted
Select one

KohenLeviYisroel
I would like to add my spouse.
PERSONAL INFORMATION – SPOUSE
Full Name*
First Name Last Name
Occupation
Work E-mail
Personal E-mail*
Home Phone Number

Area Code Phone Number
Work Phone Number

Area Code Phone Number
Cell Phone Number*

Area Code Phone Number
Hebrew Name
Bat (Father’s Hebrew Name)
Bat (Mother’s Hebrew Name)
Birth Date

Month Day Year
Jewish by

BirthConvert
Select one

KohenLeviYisroel
PERSONAL INFORMATION
Marital Status

SingleMarriedDivorcedWidowed
If divorced, do you have a Jewish "Get" ?

YesNo
Anniversary

Month Day Year
CHILDREN
Full Name
First Name Last Name
Hebrew Name
Birth Date

Month Day Year
Gender

MaleFemale
Full Name
First Name Last Name
Hebrew Name
Birth Date

Month Day Year
Gender

MaleFemale
Full Name
First Name Last Name
Hebrew Name
Birth Date

Month Day Year
Gender

MaleFemale
Full Name
First Name Last Name
Hebrew Name
Birth Date

Month Day Year
Gender

MaleFemale
Are any children adopted?

YesNo
If yes, give details, including any coversion info:
YARTZEIT INFORMATION
Name of Departed
Relationship
Hebrew Name
Ben (Father’s Hebrew Name)
Date of Passing

Month Day Year
Time of Passing

Before NightfallAfter Nightfall
Name of Departed
Relationship
Hebrew Name
Ben (Father’s Hebrew Name)
Date of Passing

Month Day Year
Time of Passing

Before NightfallAfter Nightfall
Name of Departed
Relationship
Hebrew Name
Ben (Father’s Hebrew Name)
Date of Passing

Month Day Year
Time of Passing

Before NightfallAfter Nightfall
Please click here to learn about our Memorial Board eternalizing the names of departed loved ones.
MEMBERSHIP CONTRIBUTIONS - ANNUAL
Family: $1,800 ~ Single/ Young Family/ Senior: $900
Membership Rate

Family: $1,800Single: $900
Payment Method*

Please bill meCheck, 12 post dated checksCredit Card, full paymentCredit card, 2 equal payments (one now, one in 6 months)Credit card, 12 equal payments (on first of each month)
Comments

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

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

*All contributions are tax deductible and can be paid throughout the year. No one is turned away for lack of funds. If you cannot afford the full amount requested, contact the Rabbi for a confidential arrangement.
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PERSONAL INFORMATION - Member

PERSONAL INFORMATION – SPOUSE

PERSONAL INFORMATION

CHILDREN

YARTZEIT INFORMATION

MEMBERSHIP CONTRIBUTIONS - ANNUAL