ABRIDGED FORM FOR CURRENT MEMBERS ONLY.
Signing up as a member for the first time? Click here for the full form.

Click here for our Welcome Letter 

Click here for our schedule of High Holiday services. 

Please keep us updated on these important changes in your life.
Please notify us below of any new births (or other family Simchas) or deaths.
This will enable us to keep our records current and notify you of upcoming
Yahrtzeits and have them listed in the Shul’s weekly announcements.
 
Due by Tuesday, August 15, 2023
 
SECTION I: ADULT MALE

 

 SECTION I: ADULT FEMALE

Name, First Last

 

Name, First Last

SECTION II: FAMILY UPDATE - since September 1, 2022
NEW CONTACT INFO      
New Address   New Home Phone
New Email (male)   New Cell (male)
New Email (female)   New Cell (female)
CHILDREN - born since September 1, 2022

 

  
English/Hebrew Name   Date of Birth / /
MM / DD / YYYY format
      Before / After Sundown
English/Hebrew Name   Date of Birth / /
MM / DD / YYYY format
      Before / After Sundown
YARTZEITS - of loved ones who have passed away since September 1, 2022
English Name
Hebrew Name
   Relation Date of Yartzeit / Time of Day

 

/ /
MM / DD / YYYY format

 

/ /
MM / DD / YYYY format
 

High Holiday Attendance Form 5784-2023 
All memberships include High Holiday seats. Family memberships include all minor children up to the age of 18, or children who have full-time student status.
ADULTS (enter names) CHILDREN (enter names & ages) GUESTS (enter names, list ages for kids)   Guest Rates
age age   Out of Town relatives of Members: $75 per person
age age   Local relatives of Members: $125/person
age age   Non-Members: $150/person
age age   Children: $36

Check back for the High Holiday Schedule coming soon.
Looking forward to seeing you on the High Holidays!

SECTION III: MEMBERSHIP CONTRIBUTIONS

Additional Support 
I cannot be a Chai Member donor, but I would like to make a contribution of $ above and beyond
my membership to help expand our programs and help those in need of scholarships.

I would like to contribute the above total amount per the payment schedule below:
Full Payment Bi-Annual Quarterly Monthly | Use credit/debit card below By Check
Chai Level Membership Annual Bi-Annual
(9/1, 3/1) 		Quarterly
(9/1, 12/1, 3/ 1, 6/1) 		Monthly
Chai Benefactor
$5,000.00 $2,500.00 $1,250.00 $416.66
Chai Patron
$3,600.00 $1,800.00 $900.00 $300.00
Chai Friend
$2,500.00 $1,250.00 $625.00 $208.33
General Membership Annual Bi-Annual
(9/1, 3/1) 		Quarterly
(9/1, 12/1, 3/ 1, 6/1) 		Monthly
Family
(Ages 35-65)
 $1,950.00 $975.00 $487.50 $162.50
 Senior Family
(Ages: 66 & over) 		$1625.00 $812.50 $406.25 $135.42
 Young Family 
(Ages: 30-34)		  $1,450.00  $725.00  $362.50  $120.83
Single or Single Parent $1,250.00 $625.00 $312.50 $104.17
Young Family
(Both under 30) 		$650.00 $325.00 $162.50 $54.17
Security Fee (Mandatory)   $120.00  $60.00 $30.00 $10.00
Age groups are determined by the oldest household member as of 9/1/23.
Volunteer Opportunities
I will be happy to volunteer for the following:
Helping to prepare for a Kiddush or Simcha
Helping us cook or visit those in need (i.e. birth of a child, an illness, loss in the family)
Fixing and maintaining our building
Setting up the Shul for Shabbos and Holidays
General volunteering
Call me to discuss

SECTION IV: PAYMENT OPTIONS

• Payment in full by cash, check or credit card
• Bi-Annual & Quarterly payments using a credit card only. Your credit card will be charged on the first business day of your selected payment schedule
Paying By: Check (full payment only)
Donor Advised Fund (full payment only) 
Credit Card/ Debit Card Full Payment Bi-Annual (Charges: Sept. 1, March 1)  Quarterly (Charges: Sept. 1, Dec. 1, March 1, June 1)  Monthly (Charges: Sept. 1 through Aug. 1)
Cardholder First Name: Last Name:
Cardholder's Email:  Cardholder's Signature:  
Please charge my: Visa M/C AMEX Exp. Date
Card #: CVV

 ACH Debit (Automatic transfer from your bank account - save Chabad a 3% service charge)

 Full Payment  Bi-Annual (Charges: Sept. 5, March 5) Quarterly (Charges: Sept. 5, Dec. 5, March 5, June 5)  Monthly (Charges: Sept. 5 through Aug. 5)
 
Account Type:   Checking  Saving      Date: 
Bank Name:   
Bank Routing Number:  
Bank Account Number:  
Account Holder’s Name: 
Account Holder’s Signature: 

Please allow 7 business days notice for changes to method of payment
 

SECTION VII: REQUESTS FOR FINANCIAL ASSISTANCE

Chabad of Plano wishes to accept all who want to be members and participate in its programs regardless of financial means. Our financial chair will contact you and a mutually agreed upon fee will be arranged. This will occur in a strictly confidential manner. No person or family will be turned away due to lack of financial means. Please use the following area to state reason for financial assistance request:

please contact me on my: home phone cell phone (as shown above)