NEW MEMBERS FORM
Current members: click here for the abridged "update-only" form.

Click here for our Welcome Letter

Click here for our schedule of High Holiday services.

September 1, 2023 - August 31, 2024

We invite you to join our growing family and become part of this wonderful community. High Holiday seats are included with membership.

We are a diverse group of people from various levels of observance who come together for learning, spiritual growth, social interaction and friendship.

As we head into the 2023-2024 membership year, we reflect on the Shul’s accomplishments of the past year and look forward to the future with excitement as it is filled with new opportunities for our continued growth. The success we have achieved since the opening of our building is a reflection of the dedication and support of our members. The Chabad Center is truly dependent upon the financial resources provided through the support of a committed membership base.

With the High Holidays approaching, please take a moment to submit the form below. Upon receipt, we will email you a confirmation letter for your High Holiday seats. We look forward to your support as a member of Chabad.

If you would like more information, please do not hesitate to call Chabad at (972) 596-8270. For questions regarding finances, please call our Financial Chair Stan Rothstein at (972) 931-0150.

SECTION I: ADULT MALE

SECTION II: ADULT FEMALE

Name

  

Name
Hebrew Name   Hebrew Name
Father's
Hebrew Name 		  Father's Hebrew Name
Mother's
Hebrew Name		   Mother's
Hebrew Name
Occupation   Occupation
Birth Date / /
MM / DD / YYYY format 		  Birth Date / /
MM / DD / YYYY format
Business Phone   Business Phone
Cell Phone   Cell Phone
Email   Email
Was birth mother Jewish? yes no
If not, did you convert? yes no 		  Was birth mother Jewish? yes no
If not, did you convert? yes no
Check One: Cohen Levi Israel   Check One: Cohen Levi Israel

SECTION III: PERSONAL INFORMATION

Address   Marital Status
City/State/Zip   Anniversary Date / /
MM / DD / YYYY format
Home Phone   If Divorced: If divorced, do you have a
Jewish "Get" ? Yes No

SECTION IV: CHILDREN

English/Hebrew Name

  

Birth Date

/ /
MM / DD / YYYY format

School Grade     Before / After Sundown

English/Hebrew Name

  

Birth Date

 / /
MM / DD / YYYY format
School Grade     Before / After Sundown

English/Hebrew Name

  

Birth Date

 / /
MM / DD / YYYY format
School Grade     Before / After Sundown
If any children were not born Jewish please include a copy of certificate of conversion, if applicable.

SECTION V: YAHRZEIT INFORMATION

Name
English / Hebrew / Father's Hebrew / Last 		  / /
Date of Passing: MM / DD / YYYY 		Relationship

Name
English / Hebrew / Father's Hebrew / Last 		  / /
Date of Passing: MM / DD / YYYY 		Relationship

Name
English / Hebrew / Father's Hebrew / Last 		  / /
Date of Passing: MM / DD / YYYY 		Relationship

Name
English / Hebrew / Father's Hebrew / Last 		  / /
Date of Passing: MM / DD / YYYY 		Relationship

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


Complete updated High Holiday Schedule coming soon.
Looking forward to seeing you on the High Holidays!

I am interested in participating in the following areas

Synagogue services The Plano Mikvah Gan Gani Preschool
Women's Programming Sunday Hebrew School Holiday Celebrations
Camp Gan Israel Youth Club Activities KidShul/Junior Congregation
Teen Club Activities Adult Education Classes Lending Library

I am interested in volunteering in the following areas

Leading the Service Women’s Events Committees Reading from the Torah
Holiday Events Committees Cooking for Celebrations and Kiddushim Purim Gift Basket/ Passover Matzah Deliveries
High Holiday Ushers Shabbat and Holiday Shul Setup General Volunteering

SECTION VI: 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 $1,250.0 $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) 		$1,625.00 $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.

SECTION VII: PAYMENT OPTIONS

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

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

 Full Payment  Bi-Annual  Quarterly  Monthly
 
Account Type:   Checking  Saving      Date: 
Bank Name:   
Bank Routing Number:  
Bank Account Number:  
Account Holder’s Name: 
Account Holder’s Signature: 
Funds will be withdrawn on the 5th of the month.
 

SECTION IX: 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)