Dear Friends, Chabad of Port Washington proudly serves our local community with loving kindness. This survey will give 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 Shalom M. PaltielWhat do you most enjoy about Chabad of Port Washington?Synagogue ServicesHebrew SchoolPreschoolAdult Education/ Lecture SeriesHoliday Celebrations and Jewish PrideLife Cycle Services and SupportInternational Network for all things Jewish wherever you might beDaily Minyan ServicesWhat type of adult education classes interest you?Jewish HistoryMysticismTalmudHebrew ReadingPractical Judaism CoursesDo you have a child or grandchild away at college? Chabad of Port Washington will arrange an invitation for your student to enjoy Shabbat dinner, meet new friends, and renew Jewish values at their college. Please share their information and we will do the rest.Chabad of Port Washington's Jewish Teen Network, hosts Jewish Clubs during lunchtime at many high schools. Are you interested in having a CTeen chapter established in Port Washington?Yes, I'd love that!My kids can help recruit other teens.Do you have a mezuzah on the door of your home?No, please contact me about getting a mezuzah for my home.Yes, I have a mezuzah and I would like someone to come and check it.Yes, I have a mezuzah but would like additional ones on other doors in my home.Many people like to leave a gift to charity in their will. Would you consider leaving Chabad of Port Washington in yours?I have already included Chabad of Port Washington in my will.I would definitely include Chabad of Port Washington in my will.I would probably include Chabad of Port Washington in my will.I would like to speak to someone about including Chabad of Port Washington in my will.I am not interested at this time.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.How has Chabad touched your life?What would you suggest we do to enhance the success of Chabad of Port Washington?Full Name*First NameLast NameE-mailPhone 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!Age of Children0-1213-1718-3030-60No ChildrenSubmitShould be Empty: This page uses TLS encryption to keep your data secure.
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