CSSY Tishrei Application 2020
Bringing the joy and celebration of Shabbos and Yom Tov to hundreds of homes throughout the Crown Heights community with dignity and serenity.

Kindly complete this online application so Chevra Simchas Shabbos V'YomTov can better assist you.

Should you find it difficult to complete this application, please contact us at 718-774-5270 or email cssyoffice@gmail.com.

If you feel you may need on-going assistance, please contact us after Tishrei.
Applicant First Name *
Last Name *
Spouse Name *
Applicant or Spouse Maiden (nee) Name *
Marriage Status *
How many children do you have? *
Please fill in below the name, age, and school of each of your children.
#1 - Name, Age, & School
#2 - Name, Age, & School
#3 - Name, Age, & School
#4 - Name, Age, & School
#5 - Name, Age, & School
#6 - Name, Age, & School
#7 - Name, Age, & School
#8 - Name, Age, & School
#9 - Name, Age, & School
#10 - Name, Age, & School
How many children live at home over 21? *
How many children currently live at home? *
How many children will be home for Tishrei? *
Email Address *
Address *
City *
State *
Zip *
Home Number
Cell Phone Number *
Were you working prior to the COVID-19 pandemic? *
Has your work been effected due to COVID-19? *
Did you apply for Unemployment Benefits & COVID-19 Government Relief? *
Do you rent or own a home? *
Will you be home for Tishrei? *
Are you hosting guests for Tishrei? If so, how many? *
Do you receive government assistance? Please indicate which: *
Do you receive assistance for Tishrei from other organizations? *
Reference #1 (Name & Phone Number) *
Reference #2 (Name & Phone Number) *
Please review your application before submitting to ensure all information is correct and accurate.
*Applying is not a guarantee that services will be provided.* Though CSSY will attempt to help all individuals in need of Kosher food, in the case of limited resource, the organization will prioritize candidates based on need and first come – first serve basis.
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