Intake form

Name *

Email address *

What programs are you interested in?

Please select at least one option.

Educational classes

Holiday celebrations

Community events

Volunteer opportunities

Social gatherings

How did you hear about chabad of greater hazleton?

Are you a member of the chabad community?

What is your preferred method of communication?

Please select at least one option.

Email

Phone call

Text message

In-person meeting

What topics are you interested in learning more about?

Please select at least one option.

Jewish traditions

Torah studies

Community service

Cultural events

Spiritual growth

Would you like to volunteer with us?

Additional questions or comments

Chabad of Greater Hazleton