All Jews are welcome to attend our services, regardless of background or affiliation. There is no charge for services, but your generous donation will help us in providing meaningful and inspiring services to the whole community. Please enter your reservation below, and you may complete the donation on the bottom of this form. Suggested donation is $100 per seat for reserved seating. Thank you for your support!

Your Info

First Name
Last Name
Address
City
State
Zip Code
Phone
Email

Number of Adult Attendees Name & Age of Children Attendees
Adult Name 1
Child Name 1 & Age
Adult Name 2
Child Name 2 & Age
Adult Name 3
Child Name 3 & Age
Adult Name 4
Child Name 4 & Age
Adult Name 5
Child Name 5 & Age
Adult Name 6
Child Name 6 & Age
High Holiday Services I plan to attend
Please check all that apply.
Rosh Hashanah Eve. | September 29
   
Rosh Hashanah Day 1 | September 30
 
Rosh Hashanah Day 2 | October 1
 
Yom Kippur | October 8-9
 

Donation

Help Chabad bring more light to the community with your generous contribution.

There is no membership required to join us for services.

We welcome your contribution of $100 per person for your high holiday seat.

Sponsors of $180 and up will receive honorable mention during services.
No one will be turned away for inability to pay.

Yes, I would like to reserve:

Reserved Seats - $100 each
Number of Seats
Sponsor - $180 (includes 1 seat)
Supporter - $360 (includes 3 seats)
Honorary Founder - $2,500 (includes seats for family and guests)
Other: $

Other Sponsorships

Sponsor a Prayer Book - $25.00 each
Please specify number:
 In honor of  In Memory of

Sponsor a Tallit (prayer shawl) - $55.00 each
Please specify number:
 In honor of   In Memory of

Yahrtzeits

Please let us know any Yartzeits in the family so we can send a reminder in the mail.
Name of deceased (1):
Relationship to me (i.e. mother, father):
Deceased Hebrew Name & father's name: Date of Passing:
Name of deceased (2):
Relationship to me (i.e. mother, father):
Deceased Hebrew Name & father's name: Date of Passing:
Name of deceased (3):
Relationship to me (i.e. mother, father):
Deceased Hebrew Name & father's name: Date of Passing:

Lulav Order

Kosher sets of Lulavim & Etrogim- for adults on sale for $40.
Pick up your set at Chabad- 2174 Hewlett Ave, Merrick.
Limited amount-first come, first serve!
Place your order here, or call Chabad at: 516-833-3057
Yes, I would like to purchase Kosher sets of Lulavim & Etrogim at $40 a set.

Kapparot Order

I contribute to the Chabad Kapparot Fund so that it shall be an atonement for my family and myself. In this merit may we be inscribed and sealed in the book of life.
Please include the Hebrew Name and Mother's name of each member of your family. (For info about Kapparot, click here).
Your Mother's Hebrew Name: Your Hebrew Name:
Spouse's Mother's Hebrew Name: Your Spouse's Name:
Child's Mother's Hebrew Name:
Child's Hebrew Name:
2nd child's Mother's Hebrew Name:
2nd Child's Hebrew Name:
3rd child's Mother's Hebrew Name:
3rd Child's Hebrew Name:
4th child's Mother's Hebrew Name:
4th Child's Hebrew Name:

Payment Info

I will mail/submit a check to 2174 Hewlett Ave, Suite 101, Merrick, NY 11566
Card Number
Expiration
CVV Code
Total Amount
$
Billing Address
Billing State
Billing Zip