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

Please choose your membership type:

Student $180Single $360Family $600Will donate a different amount below

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.

Mon, January 20 2020
23 Tevet 5780

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Mon, January 20 2020 23 Tevet 5780