Name Plate Memorial Plaque

Your Information

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Email Address

Information of your loved one for the Memorial Plaque

Hebrew Name

English Name

English Date of Death

Hebrew Date of Death

I hereby authorize you to supploy adn maintain permanently on your Illuminated Bronze Memorial Tablet, a solid bronze name plate In Memory of (State Your Relationship)

It is mutually agreed that each year, on the Yahrzeit of the departed, and on the other appropriate occasions in accordance with Jewish Custom, a light will be kindled at the name plate and, on such occasions, a Memorial Prayer will be said ($360 fee)

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Thu, March 5 2026 16 Adar 5786