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 PotashWhat was your most memorable Jewish experience?Family Seder at PesachLighting Chanukah CandlesShabbat DinnerVisiting IsraelIs 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 SickHoliday ProgramsShabbat ServicesAdult EducationSenior ProgrammingWhich one of these Mitzvahs would you like to learn more about?Learning about Kashrut (keeping kosher)The laws of Family PurityHow and why to light the Friday night candlesWhy we put a Mezuzah on our doorHow and why we put on TefillinAre 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 ServicesHelping set up for Holiday EventsVisiting the houseboundHave 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 NameLast NameE-mail*Phone NumberArea CodePhone NumberAddressStreet AddressStreet Address Line 2CityState / ProvincePostal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNagorno-KarabakhNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandTurkish Republic of Northern CyprusNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTransnistria PridnestrovieTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOtherCountryMarital StatusMarriedSingleDivorcedLooking for a Shidduch!Widow/WidowerAge of Children0-1213-1718-3030-60No ChildrenSubmitShould be Empty: This page uses TLS encryption to keep your data secure.