Membership Dues – Lake Chapala Jewish Congregation

LAKE CHAPALA JEWISH CONGREGATION

2018-2019 MEMBERSHIP ENROLLMENT FORM

Annual Dues: $6000 Pesos PER PERSON

Make checks payable to Lake Chapala Jewish Congregation, A.C.

Fields marked with an * are required

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Primary Member First Name *

Primary Member Last Name *

Primary Email *

Primary Phone *

Secondary Member First Name

Secondary Member Last Name

Secondary Email

Secondary Phone

Local Address

Emergency Contact Name

Emergency Contact Phone

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Checkbox List

Jewish through matilineal or partilinial descent
Jewish by choice (conversion)
Spouse or partner of a Jewish member
Parent or guardian of a jewish child
Actively committed or exploring the process of conversion to Judaism

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YAHRZEITS TO BE REMEMBERED:

1. Name, Relationship, Date (Separate with comma)

2. Name, Relationship, Date (Separate with comma)

3. Name, Relationship, Date (Separate with comma)

4. Name, Relationship, Date (Separate with comma)

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I/We Pledge: *

1 person: $6000 pesos
2 people: $12000 pesos

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No one will be turned away due to an inability to pay the full membership amount. Send email to hayden365@yahoo.com for confidential arrangements.

Please stay on this page once your enrollment has been submitted to receive PAYMENT INSTRUCTIONS.

Lake Chapala Jewish Congregation

LAKE CHAPALA JEWISH CONGREGATION

2018-2019 MEMBERSHIP ENROLLMENT FORM

Annual Dues: $6000 Pesos PER PERSON

Make checks payable to Lake Chapala Jewish Congregation, A.C.

Location

Santa Margarita #113, Riberas del Pilar

Jalisco, México

C.P. 45906

Membership

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Location

Santa Margarita #113, Riberas del Pilar

Jalisco, México

C.P. 45900

Membership

Service Leader Fund

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Join Us