New Membership Form 2024 Onward

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Chaverim Membership Form

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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.

First Name *

Last Name *

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Nickname

Address Line 1 *

Address Line 2

City *

State/Province

Zip/Postal Code *

Country *

Email *

Phone 1 *

Religion

Synagogue Affiliation (only if applicable)

Occupation

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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

Address Line 1 *

Address Line 2

City *

State/Province

Zip/Postal Code *

Country *

Email *

Phone 1 *

Birthday *

Religion

Synagogue Affiliation (only if applicable)

Occupation

Add {{subMemberDisplayName}}

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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:

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Order summary

Subtotal {{formatAmount(orderSummary.subtotal)}}

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

Total {{formatAmount(orderSummary.total)}}

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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}}
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