Dear Friend, Chabad of Rechavia proudly serves our local community with loving kindness. This questionnaire will give us a better idea of how we can serve you best. As you answer the following questions, please remember, we keep all replies confidential. Rabbi Yisroel Goldberg What do you most enjoy about Chabad of Rechavia ? Shabbat Minyan & Weekly Kiddush Adult Education / Lecture Series Children's Programs Women's Events What type of adult education classes interest you? Jewish History Mysticism Talmud Hebrew Reading JLI Courses Do you have a child or grandchild away at college? Let Chabad of Rechavia invite your student to enjoy Shabbat dinner, meet new friends, and renew Jewish values. Please share their information and we will do the rest. Do you have a parent or elderly relative in this or any other community, who would welcome a visit from a Rabbi? Please list them below. Do you have a mezuzah on the door of your home? No, please contact me about getting a mezuzah for my home. Yes, I have a mezuzah and I would like someone to come and check it. No thank you. Many people like to leave a gift to charity in their will. Would you consider leaving Chabad of Rechavia in yours? I have already included Chabad of Rechavia in my will. I would definitely include Chabad of Rechavia in my will. I would probably include Chabad of Rechavia in my will. I would like to speak to someone about including Chabad of Rechavia in my will. I am not interested at this time. How has Chabad touched your life? What would you suggest we do to enhance the success of Chabad of Rechavia? Full Name* First Name Last Name E-mail Phone Number Area Code Phone Number Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Marital Status Married Single Divorced Looking for a Shidduch! Age of Children 0-12 13-17 18-30 30-60 No Children Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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