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Synagogue Our Synagogue

Jewish Memorial Board

Dear Friends of Chabad:

In order to remember our loved ones that have passed on, we have installed in our Synagogue,

an elegant bronze memorial tablet for the purpose of inscribing and eternalizing the names of our

departed ones.

Names inscribed on the plaque will have their Yahrtzeit observed in the following traditional manner:

A. On Yom Kippur, Sukkos, Pesach, and Shavuos, the Yizkor prayer will be recited for the

names of the departed.

B. A Kiddush/Lunch Gathering of friends and family to remember your loved ones, can be

arranged on the Shabbat around the time of the Yahrzeit.

C. An email will be sent to you a couple of days before the Yahrtzeit.

The initial cost for inscription on a Bronze Plaque is $1,000. Each year thereafter, a contribution of

any size will be accepted on the Yahrtzeit Day.
DONOR INFORMATION (individual ordering the plaque)
Full Name*
First Name Last Name
E-mail*
I would like to receive news and updates by email
Phone Number*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

I would like to dedicate the following number of plaques:*
$1,000/plaque
DEDICATION PLAQUE
Please inscribe the following name on the memorial tablet:
PLAQUE #1
Full Name
First Name Last Name
Hebrew Name
First Name Last Name
Father's Hebrew Name
First Name Last Name
Date of Passing

Month Day Year
After Dark?

YesNo
PLAQUE #2
Full Name
First Name Last Name
Hebrew Name
First Name Last Name
Father's Hebrew Name
First Name Last Name
Date of Passing

Month Day Year
After Dark?

YesNo
Total

$0.00

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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