Membership

Full Name*

First Name Last Name

Hebrew Name

Phone Number*

Area Code Phone Number

E-mail*

Check all that apply*

Born to a Jewish mother Convert Kohen Levy

Spouse's Full Name

First Name Last Name

Spouse's Hebrew Name

Spouse's Phone Number

Area Code Phone Number

Spouse's E-mail

My Spouse

Was born to a Jewish mother Converted to Judaism

Family Members & Relationship to You Include names of dependents

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

I am paying*

Monthly Yearly

I would like the following membership:
Membership includes cemetery plots at the Pardes Chaim Cemetery (conditions apply)

Regular Membership

Chai Membership $1,800 ($150 per month) Includes: 2 seats plus dependent children Family: $1,500 ($125 per month) Includes: 2 seats plus dependent children Single Parent: $870 ($72.50 per month) Includes: 1 seat plus dependent children Senior Family: $1,000 ($84 per month) Includes: 2 seats Senior Single: $540 ($45 per month) Includes: 1 seat

New Members

New Family (1st year only): $960 ($80 per month) Includes: 2 seats plus dependent children New Single (1st year only): $500 ($42 per month) Includes: 1 seat

Newlywed Membership

First Year Marriage: $600 ($50 per month) Includes: 2 seats Second Year Marriage: $840 ($70 per month) Includes: 2 seats Third Year Marriage: $960 ($80 per month) Includes: 2 seats

Regular Membership

Chai Membership $1,800 - Includes: 2 seats plus dependent children Family: $1,500 - Includes: 2 seats plus dependent children Single Parent: $870 - Includes: 1 seat plus dependent children Senior Family: $1,000 - Includes: 2 seats Senior Single: $540 - Includes: 1 seat

New Members

New Family (1st year only): $960 - Includes: 2 seats plus dependent children New Single (1st year only): $500 - Includes: 1 seat

Newlywed Membership

First Year Marriage: $600 - Includes: 2 seats Second Year Marriage: $840 - Includes: 2 seats Third Year Marriage: $960 - Includes: 2 seats

HIGH HOLIDAY TICKETS MUST BE RESERVED HERE

I would like to make an additional donation of:

Special reason for donation:

Total

$0.00 CAD

Payment Method*

Credit Card

Credit Card Type
Credit Card Number	Security Code
Expiration Month	Expiration Year

Thank you for being a part of our community!
All payments will receive a full tax receipt

*We maintain Chabad’s policy to ensure you are welcome regardless of payment

Complete Service Schedule HERE

Personal Information

Membership

Donation

Payment