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Chaverim Membership Form

Include a submember in your membership registration

PLEASE NOTE: ApplePay will not work for recurring monthly or annual membership terms. Although ApplePay was enabled globally in our system, we do not recommend that you use it for membership, only event registrations and campaign donations. Please select Pay With Card instead.

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I would like to automatically renew my membership

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First Name *

Last Name *

Submit as a company

Nickname

Occupation

Religion

Synagogue Affiliation (only if applicable)

Email *

Phone 1 *

Address Line 1 *

Address Line 2

City *

State/Province

Zip/Postal Code *

Country *

Timezone

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Include a submember

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Choose Existing Contact(s)

Membership Level *

I would like to automatically renew my membership

First Name *

Last Name *

Nickname

Occupation

Religion

Phone 1

Address Line 1 *

Address Line 2

City *

State/Province

Zip/Postal Code *

Country *

Birthday *

Add {{subMemberDisplayName}}

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{{orderSummary.membershipsTotal==0?'Free':formatAmount(orderSummary.membershipsTotal)}}

Membership auto-renews monthly for {{ formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipInstallment.cost) }} until {{ orderSummary.membershipOrderItem.membershipInstallment.endDate }}

Membership auto-renews on {{orderSummary.membershipOrderItem.membershipAutoRenew.renewDate}} for {{formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipAutoRenew.cost)}}

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Membership auto-renews monthly for {{ formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipInstallment.cost) }} until {{ orderSummary.membershipOrderItem.membershipInstallment.endDate }}

Membership auto-renews on {{orderSummary.membershipOrderItem.membershipAutoRenew.renewDate}} for {{formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipAutoRenew.cost)}}

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{{sm.startDate}} - {{sm.endDate}}

Membership auto-renews monthly for {{ formatAutoRenewAmount(sm.membershipInstallment.cost) }} until {{ sm.membershipInstallment.endDate }}

Membership auto-renews on {{sm.membershipAutoRenew.renewDate}} for {{formatAutoRenewAmount(sm.membershipAutoRenew.cost)}}

Frequency selected: {{recurringUnitText}}. Next add-on payment processes on {{orderSummary.recurringDonationNextDate}} for {{formatAmount(orderSummary.donationAmount)}}

Discount Code

Code:

-{{formatAmount(orderSummary.codeDiscount)}}

Order summary

Subtotal {{formatAmount(orderSummary.subtotal)}}

Discounts -{{formatAmount(orderSummary.discounts)}}

Total {{formatAmount(orderSummary.total)}}

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Card

ACH

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Cardholder First Name *

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Billing address is the same as mailing address

Address Line 1

Address Line 2

City

State/Province

Zip *

Country

Select Pay Later to mail your membership payment check to:

The Mussar Institute

1025 Gateway Blvd, #303-318

Boynton Beach, FL 33426

PLEASE NOTE: YOUR MEMBERSHIP BENEFITS WILL NOT ACTIVATE UNTIL PAYMENT IS RECEIVED.

I will mail in a check or money order

Please mail your payment to:
1025 Gateway Blvd.
#303-318
Boynton Beach, FL 33426

Amount:

{{formatAmount(totalAmount)}} USD

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Membership level allows for a maximum of {{term.subMemberAllowed}} submembers.

	Contact Name	Membership Level
	{{item.contactName}}	{{item.membershipLevel==null?'-':item.membershipLevel}} {{item.startDate}} - {{item.endDate}}
No contacts.