Jewish Community Survey

Dear Friends,

Shaloh House Chabad proudly serves our local community with loving kindness. We continuously evaluate our success to give us a better idea how to serve you best. We would like to ask you to take a moment and fill out our community survey below. As you answer the following questions, please remember, we keep all replies confidential.

Rabbi Mendel & Chana Gurkow

What was your most memorable Jewish experience?

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 Shaloh House do you most admire?

Every month Shaloh House sends out Yahrtzeit reminders to families to remember their loved ones. Would you like us to do the same for you?

Please include persons English name and Hebrew name with Fathers Hebrew name.

MonthDayYear

at HourMinutes

Which one of these Mitzvot would you like to learn more about?

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 Shaloh House?

Have you ever been to Israel? Would you be interested in joining Shaloh House 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 Shaloh House 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 Shaloh House in yours?

I have already included Shaloh House in my will.I would definitely include Shaloh House in my will.I would probably include Shaloh House in my will.I would like to speak to someone about including Shaloh House in my will.I am not interested at this time.

What would you suggest we do to enhance the success of Shaloh House?

Full Name*

First NameLast Name

Birth Date

MonthDayYear

E-mail

Phone Number

Area CodePhone Number

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Marital Status

Age of Children

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