Request to join a Chavurah
Privacy Statement: All personal information provided will be kept confidential.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Phone Type
mobile
home
Marital Status
*
Married/Domestic partner
Divorced
Single
Widowed
Name of Spouse/Significant other
Children - if applicable
Child #1
First Name
Last Name
Sex
Age
Birthday
Live with you?
Yes
No
Child #2
First Name
Last Name
Sex
Age
Birthday
Live with you?
Yes
No
Child #3
First Name
Last Name
Sex
Age
Birthday
Live with you?
Yes
No
Chavurah Interests
What type of Chavurah would you like to participate in? (Check all that apply)
*
Adult Singles
Senior Singles
Adult Couples
Senior Couples
Singles w/Children under 3
Couples w/Children under 3
Singles w/Children between 3 and 6
Couples w/Children between 3 and 6
Singles w/Children 6-12
Couples w/Children 6-12
Singles w/Teens
Couples w/Teens
Interfaith Couples
Grandparents/Parent/Grandchildren
Varied types & ages
Other
How far are you willing to travel to meet as a Chavurah?” ___ miles
miles
Have you already made contact with one or more people who would like to be in the same Chavurah but are looking for additional members to round out the group?
Yes
No
Please list them here and ask them to complete a form as well
Is there an existing Chavurah you would like to join?
Yes
No
If yes, please provide the names of the Chavurah Participants
Please rank your goals for joining a Chavurah (1 = Most Important)
*
Ranking
Celebrate holidays
Socialize with other NVHC members
Create an “extended family”
Expand Jewish knowledge
Become more involved with NVHC
Meet Jewish people who live nearby
Meet religious school classmates/families
Meet people of similar age/situation
Celebrate Shabbat
Please indicate what you would like to do with your Chavurah (check all that apply)
*
Holiday Celebrations
Adult Social Activities
Shabbat Celebrations
Travel to Places of Jewish Interest
Community Service
Activities w/Children
Sports
Movies/Theatre
Discussion Groups
Religious Study
Attend Religious Services
Participate in Temple Events/Activities
Other
What size Chavurah would you prefer?
*
Small (4-5 families)
Medium (5-7 families)
Large (7-10 families)
Not sure
Is there anything else we should know before we match you with a group (dietary restrictions, allergies, pet issues, special needs, etc.)?
Do you envision gatherings in each other’s homes or outside the home? If at home, what’s the maximum number of people you would feel comfortable hosting in your home?
Please describe your interests and hobbies.
Have you been involved with other Chavurah groups? What do you think made them a success? What could have been done differently to make them more successful?
Chavurah groups will be organized as soon as enough applications are received to form a new group or if there is an opening in an existing Chavurah that fits your needs.
Submit
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