The Day of Awe and the joyous holidays of Sukkot and Simchat Torah: a holiday-crammed month! Join us and come pray with us. We want to be here for you, please be there for us! Support Chabad of Golden Beach, become a member and enjoy our beautiful Synagogue, our daily services, our holidays and happy celebrations. Please fill out the form below and submit, or call us and come to see us from Monday to Thursday from 10 to 5. Chabad of Golden Beach 19201 Collins Ave. inside the Ramada Marco Polo.

	First Name: A value is required. Last Name: A value is required. Home Address: A value is required. State: A value is required. Zip Code : A value is required. Phone: A value is required. Fax: Cellular: e-mail address: A value is required. Occupation / Profession / Specialization: Business Address: State: Zip Code : Business Phone: Marital Status : Date of Anniversary: Date of Birth :     After Sunset: After Sunset: Is Mother born Jewish?   Yes   No (If converted, please show papers of Orthodox Conversion) Hebrew Name /First: Hebrew Name /Last: Father Name : Mother Name : Kohen Levi Yisrael Parent's Country of Origin:  / National Background: SPOUSE'S First Name: Last Name: Occupation / Profession / Specialization: Business Address: State: Zip Code : Business Phone: Fax: Cellular: Is Mother born Jewish? Yes No (If converted, please show papers of Orthodox Conversion) Hebrew Name /First: Hebrew Name /Last: Father Name : Mother Name : Parent's Country of Origin: / National Background: CHILDREN Full Name / Hebrew Sex Birth Date Grade School Attending M  F M  F M  F M  F HAZKAROT (YARTZEITS) Full Name Date of Death Relationship After Nightfall Yes  No Yes  No Yes  No I AM MOST INTEREST IN THE FOLLOWING PROGRAMS: M  F Sisterhood M  F Youth Programs M  F Adult Education M  F Hebrew School M  F Singles Programs M  F Choir of Boys M  F Daily Minyan M  F Shabbat Services M  F Bar Mitzvah Center M  F Classes in: M  F Bar Mitzvah Club   French  Hebrew  Spanish Other: I AM WILLING TO HELP OUT WITH: M  F Hospitality M  F Public Relations / Advertisement M  F Membership M  F Newsletter M  F Program Development M  F Community Service M  F Telephone Squad M  F Sport Group M  F Tzedakah Campaign M  F Rosh Hodesh Classes, etc. (At Home) M  F Annual Dinner / Journal M  F Concerts M  F Fund Raising M  F Kiddush / Seudat Shlichit M  F Office Help M  F Food Distribution to the Neddy Other: MEMBERSHIP TYPES Partner $1,800     Family $1,200 Single $600         SECURITY EQUIPMENT FEE Only Firt Month $200                     Greetings card for community $36 METHOD OF PAYMENT Credit Card Type: Visa MasterCard American Express Credit Card Number: A value is required.Invalid format. Name as it appear on Card: A value is required. Security Code: A value is required. Expiration Date : Month:    A value is required.         Year:  A value is required. Twelve equal monthly payments