Prospective Member Intake Form - Levine Jewish Community Center, Charlotte, NC

Thank you for your interest in the Levine JCC! This short form helps us personalize your visit and ensure your tour reflects what matters most to you.

CONTACT INFORMATION

How did you hear about the Levine JCC? (check all that apply)

If you selected "other," please specify:

HOUSEHOLD INFORMATION (Optional)

Who will be using the JCC?

Individual Couple Family Not yet decided

Children in household (ages only, if applicable)

Are you new to the Charlotte area?

Yes No

YOUR INTERESTS

If you selected "other," please specify:

Which 1-2 areas are your top priorities?

YOUR GOALS

What are you hoping the JCC will add to your or your family's life?

What prompted you to explore membership at this time?

What would you like to accomplish in the first 3 months of your experience?

What best describes what you are looking for?

A social community A mostly self-directed experience A mix of both

Is there anything else you'd like us to know?

SCHEDULE A TOUR

Should you wish to schedule a specific date/time for a tour, please list it below. You are welcome to simply stop by at your convenience.