Family Information Form

No One Alone. No One Forgotten. B"H

HOME
OUR PROGRAMS
ABOUT US
CONTACT US
VOLUNTEER
BLOG
DONATE
Menu Menu

LinkedIn
Facebook
Instagram

This form is for family members only. If you are an inmate that would like to join Aleph, please write to our Florida address: 9540 Collins Ave. Surfside, FL 33154
First Name *
Last Name *
Maiden Name (if applicable)
D.O.B. (##/##/####) *
Marital Status *
MarriedSingleDivorcedWidowed
Address *
City *
State *
Zip *
Home Phone
Cell Phone *
Email *
Are you Jewish? *
YesYes, by Conversion*No
*Conversion Rabbi
Do you have a Hebrew name? If so, what is it?
Are you affiliated with a Synagogue/Temple? If yes, what's the name?
Do you have any children?
Child #1 Name
D.O.B. (##/##/####)
Male/Female
MF
Hebrew Name
Which school does he/she attend?
Child #2 Name
D.O.B. (##/##/####)
Male/Female
MF
Hebrew Name
Which school does he/she attend?
Child #3 Name
D.O.B. (##/##/####)
Male/Female
MF
Hebrew Name
Which school does he/she attend?
Child #4 Name
D.O.B. (##/##/####)
Male/Female
MF
Hebrew Name
Which school does he/she attend?
If you have more children, please submit them in the comments section below.
Relative Incarcerated Name
How are you related?
Facility Name & State
Inmate #
Hebrew Name
Please check which services you are interested in:
Camp for kidsTherapyMentor programSupport GroupVisitationConnect with Another Member of AlephFamily ProgramsConnect with Local CommunityHebrew SchoolJewish Day SchoolBar/Bat MitzvahUrgent Financial Assistance
Other
Comments/Suggestions

Verification

Please enter any two digits *
This box is for spam protection - <strong>please leave it blank</strong>:

About Aleph Institute

The Aleph Institute addresses the needs of thousands of individuals in institutional environments such as prisons, mental health facilities, and rehabilitation centers. Aleph also provides spiritual support for thousands of military personnel in the United States Armed Forces across the globe.

National Headquarters

Joseph & Sterna Gutnick
National Headquarters
Prison and Military Services
9540 Collins Avenue
Surfside, Florida 33154-7127

Phone Number:
305-864-5553
Fax Number
305-864-5675

West Coast

Los Angeles Office
Advocacy & Alternative Sentencing
7304 Beverly Blvd #153
Los Angeles, CA 90036

Phone Number:
310-598-2142
Fax Number:
323-297-4380

East Coast

New York Office
Family Services
543 Maple Street. (Suite 1)
Brooklyn, NY 11225

Phone Number:
347-76-ALEPH (25374)
Fax Number:
212-918-3468

Scroll to top