Membership Application

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West Side Sephardic Membership Application

If you plan to pay by check, log in to your account first. Then fill out this form and follow the instructions at the bottom

* Are you renewing your membership or joining for the first time?

Please Select OneNew memberMembership Renewal

We want everyone to be included. If you cannot afford the price of our membership but would like to be a member, enter here the amount you can afford

You will have an option to split the payment on the next page

Name

* First

Middle

* Last

* Email Address

Address

* Street Address

Address Line 2

* City

* State

* Zip/Postal Code

* Country

* Primary Phone

Other Phone

* Membership fees cover only 25% of our expenses. We invite you to make an additional contribution here.

Please enter $0 if you do not with to make an additional contribution.

Notes or Comments

Total Contribution:

If you would like to pay with a check, please sign in to your account. You will then get an option to “bill to account” in the payment process.

Please send your check to:

West Side Sephardic Minyan
c/o Itai Azulay
309 West 93rd Street, Apt 2A
New York, NY 10025

Please note that sending a check alone is not adequate for registration, you need to complete the registration process online to register.

Tue, December 11 2018
3 Tevet 5779

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Tue, December 11 2018 3 Tevet 5779