Membership Information

Individual & Family Memberships include:

Hebrew school reduced tuition
Bar/Bat Mitzvah facilitation
Life Cycle facilitation
50% discount on Social Hall rental
Jewish Learning Institute (JLI) class discounts
Synagogue Burial Plot Purchase

Enhanced Membership Also includes:

Priority reservation on kiddush sponsorship for one occasion of your choice (Please call 614-939-0765 to reserve your date)

Associate Membership includes:

Jewish Learning Institute (JLI) class discounts

Thank you for supporting The Lori Schottenstein Chabad Center Programs

Membership

I am a returning student from 2025-2026

If you are renewing your membership from 2025-2026, the only information required on this form is any information that has changed.

Membership Billing (One-Time/ Monthly

One Time

Monthly

Contact Info

Member Information

Member First Name

Member Last Name

Member Jewish Name

Member Birthdate

Member Birth Time (am/pm)

Member's Mother's Jewish Name

Member Father's Jewish Name

Member Employer

Additional Member Information

Additional Member First & Last Name

Additional Member Jewish Name

Additional Member Birthdate

Additional Member Birth Time (am/pm)

Additional Member's Mother's Jewish Name

Additional Member's Father's Jewish Name

Additional Member Employer

Address Information

Street Address

Unit or Apartment Number

City

State or Province

Postal Code

Country

Phone Number

Email Address

Yes, I would like to receive email communications.

Children (For Family Memberships)

Child Name

Hebrew Name

Birthdate

AM or PM

Child Name

Hebrew Name

Birthdate

AM or PM

Child Name

Hebrew Name

Birthdate

AM or PM

Child Name

Hebrew Name

Birthdate

AM or PM

Add another child?

Yes

Add another child?

Yes

Add another child?

Yes

Registration Additions

How would you like to submit Yizkor Booklet names?

Pay per name ($36 each)

Unlimited names ($150 flat)

Please enter the name(s) you would like to appear in the "Dedicated By" section of the Yizkor Booklet.

How many names would you like to include?

Please enter the name(s) you would like to include in the Yizkor Booklet

Name 1

Name 2

Name 3

Name 4

Name 5

Name 6

Name 7

Name 8

Name 9

Name 10

Yizkor Booklet

Yes

High Holiday Aliyah ($400)

Yes

Kiddish Sponsorship ($500)

Yes

Special High Holiday Aliyah ($1,000)

Yes

Wall of Remembrance Plaque ($1,000)

Yes

Yizkor Booklet Fee

Wall of Remembrance Information

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Family Yahrzeit

Number of Family Members

Family Member 1

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Family Member 2

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Family Member 3

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Family Member 4

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Family Member 5

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Family Member 6

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Family Member 7

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Family Member 8

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Family Member 9

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Family Member 10

Name of Deceased

Hebrew Name of Deceased

Relationship

Date of Passing

Time of Passing

Day/Evening

Mother's Hebrew Name (if known)

Father's Hebrew Name (if known)

Payment Info

Card Number

Expiration Date

Name On Card

CVV Code

Account Number

Routing Number

Name On Account

Account Type

Checking

Savings

Billing Street Address

Billing Unit or Apartment Number

Billing City

Billing State or Province

Billing Postal Code

Billing Country