Dear Friends, Chabad MidPen proudly serves our local community with loving kindness. Our annual survey gives us a better idea of how we can serve you best. As you answer the following questions, please remember, we keep all replies confidential. Rabbi Levi Potash What was your most memorable Jewish experience? Family Seder at Pesach Lighting Chanukah Candles Shabbat Dinner Visiting Israel Is there any one person, past or present, who "lit the spark" that began your Jewish journey? What inspires you to lead a more Jewish life? What activity at Chabad MidPen do you most admire? Visiting the Sick Holiday Programs Shabbat Services Adult Education Senior Programming Which one of these Mitzvahs would you like to learn more about? Learning about Kashrut (keeping kosher) The laws of Family Purity How and why to light the Friday night candles Why we put a Mezuzah on our door How and why we put on Tefillin Are you or a loved one undergoing a major medical procedure within the next few months? Can we offer support to you and your family? Are you interested in helping out at our Chabad house? Preparing the Shul for Shabbat Services Helping set up for Holiday Events Visiting the housebound Have you ever been to Israel? Would you be interested in joining Chabad on a community trip to Israel? I have not been to Israel and I'm interested in joining a community trip. I have already been to Israel and I'm interested in joining a community trip. I am not interested in a community trip to Israel at this time. Do you have a child or grandchild away at college? Let Chabad MidPen invite your student to enjoy Shabbat dinner, meet new friends, and renew Jewish values. Please share their information and we will do the rest. Many people like to leave a gift to charity in their will. Would you consider leaving Chabad MidPen in yours? I have already included Chabad MidPen in my will. I would definitely include Chabad MidPen in my will. I would probably include Chabad MidPen in my will. I would like to speak to someone about including Chabad MidPen in my will. I am not interested at this time. What would you suggest we do to enhance the success of Chabad MidPen? Full Name* First Name Last Name E-mail* Phone Number Area Code Phone Number Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Marital Status Married Single Divorced Looking for a Shidduch! Widow/Widower Age of Children 0-12 13-17 18-30 30-60 No Children Submit Should be Empty: This page uses TLS encryption to keep your data secure.