The Northern Canberra Synagogue and Jewish Community Centre

(Trading name for Chabad ACT Ltd)

3 Gari Place Giralang, Canberra ACT 2617 Australia 02 62419181 ABN 85163930372

Membership Form (Whilst Membership for the Synagogue is primarily open for people of the Jewish Faith, all are welcome to become a friend of the organisation and participate in most of the communities events and services.)

I hereby apply for membership/friendship for the Northern Canberra Synagogue and Jewish Community Centre for the Jewish year 5781.

My Full name is

My Address is

My Date Of Birth is

My Telephone Numbers are: Home Work

Mobile My Email Address is

(By providing an email address I agree to be provided with notices and documents electronically)

My Jewish Name is (If different than above)

My Mothers Jewish Name is (if applicable)

My Fathers Jewish Name is (if applicable)

My spouse and children's Names and date of birth are (if applicable). Please note Jewish names as well where applicable. 


If you have loved ones who have passed please specify the relationship and dates of their yohrtzeit(s)

I agree to become a member/friend of the Northern Canberra Synagogue and Community Centre and to pay the membership/friendship fee.

Signed Dated

Special Comments/Needs/Feedback

You will only be on the Member Register on receipt of Payment and notification of Acceptance of this Application Form.

Membership costs for 5781 remain unchanged.

Annual Membership: $100 for Adults (18 and over). $180 for couples and $260 for families. Students and pensioners $50 (more information including subsidies which are available for those who need can be received by contacting us here.)

Membership/Friendship Benefits apart from all the regular benefits of belonging to a caring community, include discounts to all charged community and educational services.

  • Phone: Call +612 (02) 6241 9181 Emergency Number +61 (0)431 677 805
  • Mail: 3 Gari Pl, Giralang ACT 2617
  • Online:
    • Fill-in secure form here to pay online or to review other payment options.