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* First Name

Spouse Name

* Last Name

* Street Address

* City

* State

* Zip

Home Phone

Husband Cell

Wife Cell

* Email Address

Spouse Email Address

Members of Family (Name, age, birthday):

Yahrtzeits (Name, relationship, date):

Membership Levels:

Elite Membership^{^}: $2100 ($175 per month) + $100 Mandatory Security Fee
1 Sponsored Kiddush of your Choice (dep. on availability, first come, first served)
Includes 6 seats for the Yomim Noraim

Family Membership^{*^}: $1300 ($108.33 per month) + $100 Mandatory Security Fee
Includes 4 seats for the Yomim Noraim

Young Member Family (under 30) / First Time Member Family- $750 + $100 Mandatory Security Fee
Includes 4 seats for the Yamim Noraim
Individual Membership^{*^}: $700 + $50 Mandatory Security Fee
Includes 1 seat for the Yomim Noraim

Young Member Individual (under 30) / First Time Member Individual: $400 + $50 Mandatory Security Fee
Includes 1 seat for Yomim Noraim

Weekday Membership: $600 (No Seats for Yomim Noraim)

Associate Membership: $360 (No Seats for Yomim Noraim)

Seats Only for Rosh Hashanah and Yom Kippur (as well as extra seats for Elite, Family and Individual membership levels):
Guests - $180, Students - $118, Children (<18) - $75
Note: Family membership is for married couples and families while individual membership is designated for unmarried individuals. Weekday and Associate Memberships are for those for whom Mikor is not their primary shul.
If you have any other questions regarding seats for Rosh Hashanah and Yom Kippur or membership please contact Leah Kustiner in the office at secretary@mikorhachaim.org or 773-856-0103

* Membership Type

Please Select OneElite Membership ($2100)Family Membership ($1300)Young Member Family (under 30)/First Time Member Family ($750)Individual Membership ($700)Young Member Individual (under 30) / First Time Member Individual ($400)Weekday Membership ($600)Associate Membership ($360)Seats Only

Your membership includes 6 seats. How many of these seats will you be using this year?

Your membership includes 4 seats. How many of these seats will you be using this year?

Your membership includes 1 seat. How many of these seats will you be using this year?

Do you need additional seats?

Guest Seats ($180)

Student Seats ($118)

Child Seats ( until 17) ($75)

Choose Your Seats

Please complete the section below to ensure seating accommodations are made for everyone in your family/group.

Name - Enter each person in your group on a separate line. For additional lines, increase the number of additional seats specified above.
Location - Select the location - men or women section, or Early Minyan.
When - Please let us know if you will be here for both Rosh Hashana and Yom Kippur.
Seating Selection Notes - Seating requests, etc. Please indicate any requests for seats as e.g. 'A1', 'U2' front, back, etc. Please note that while we will try, we cannot guarantee that your request will be met.

Please understand that we frequently reach full capacity on the Yomim Noraim. Please be mindful of this and only request as many seats as you realistically plan on using. If you plan on using all the seats that you are entitled to, we are excited to accommodate all of your requests.

Please note: Early Minyan is open seating

Seating Charts: Men Women

Who needs seats?

	* Name	Location	When	Notes

Babysitting
Sign up for babysitting for Rosh Hashanna and Yom Kippur. The cost is $10 per child, $30 total for family.

Note: Youth groups are open to children ages 3-10 (Pre-nursery-5th grade). The parent-tot room for children under three years old will also be available. Please note this room is not supervised by a youth group leader.

Select the number of children to be signed up

Enter the name and age of each child. Click on the plus sign to add additional rows.

* Child's First Name

* Child's Last Name

* Age

Additional Donations

If you would like to make additional donations bundled with your membership payment, please enter them below.

Yizkor

Security

Youth Groups

Building Fund
Our beautiful building is maintained by people like you. Join our Building Fund and get a personalized Shtender.

Platinum Level - $3000 includes shtender

For those who choose Platinum Level and would like to split payments over more than 12 months, please contact the office at secretary@mikorhachaim.org or 773-856-0103.

Building Fund

Security Fee Family Membership: $100 (included)

Security Fee Individual- $50

Would you like to contribute to our Rabbis' Discretionary Fund?

The Rabbis are collecting for families in need in our community, please contribute generously. May it be a zechus for you and your family at this time of year.

Website Sponsored In Honor Of: Rabbi Phil Karesh, Shlita

Website Sponsored In Honor Of: Rabbi Phil Karesh, Shlita

Rabbi Phil Karesh, Shlita

Membership

Additional Donations