Chevra Kadisha Registration Form

Registering your chevra creates no obligation and will benefit the public by helping anyone looking for a Chevra Kadisha contact in your city or community. It will also allow us to communicate with you directly. If you have any questions email us at info@nasck.org , or call us at (718) 847-6280.
Today's Date:
Contact Information
Title: First: Middle: Last:
Address:
City: State: Zip:
Phone: Fax: Cell: Email:
Relationship to Chevra Kadisha:
Chevra Information
Name of Chevra:
Address:
City: State: Zip:
Email: Phone: Fax:
Chevra Chairperson (Men's):
Phone: Cell: Email:
Chevra Chairperson (Women's):
Phone: Cell: Email:
Synagogue Affiliation
(Please fill out if you are affiliated with a synagogue)
Synagogue Name:
Address:
City: State: Zip:
Email: Phone: Fax:
Rabbi:
 
Synagogue Name:
Address:
City: State: Zip:
Email: Phone: Fax:
Rabbi:
 
Synagogue Name:
Address:
City: State: Zip:
Email: Phone: Fax:
Rabbi:
Chevra Services
Does your Chevra have cemetery plots?
Cemetery:
Cemetery:
Cemetery:
Which funeral homes do you service, and what are their phone numbers?
Name: Phone:
Name: Phone:
Name: Phone:
Name: Phone:
Do you work in non-Jewish Funeral Homes?
Does your chevra service the community at large?


Would you like your chevra members to receive our newsletter?
Member Email: Member Email:
Member Email: Member Email:
Member Email: Member Email:
Comments:  

 

Please fill out and click the submit button below, or send to:

National Association of Chevra Kadisha
85-18 117th Street
Richmond Hill, NY 11418
(718) 847-6280
Fax: (718) 847-2989