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Chabad of SCV Memorial Board - Order Form
Names inscribed on the plaque will have their Yahrtzeit observed in the following manner:
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The memorial bulb will be lit during the month of the yahrtzeit and for all Yizkor Services.
- Yizkor will be said for your deceased if for some reason you cannot be there.
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If you order the Plaque + Kaddish, we will have someone say Kaddish on the Yahrtzeit annualy.
Cost
$360 for Plaque
$500 for the plaque + Kaddish.
For more information, assistance or to discuss a payment plan, please call
661-644-5735
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DONOR INFORMATION (individual ordering the plaque) |
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First name |
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State
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Last name
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Zip
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Address
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Email
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City
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Phone |
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DEDICATION PLAQUE
I would like to dedicate
plaque/s at $360 per name/plaque.
I would like to dedicate
plaque/s + Kaddish at $500 per name/plaque.
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Please inscribe the following name on the memorial tablet:
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PLAQUE #1
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PLAQUE #2
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Last Name
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Last Name
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First Name
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First Name
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Hebrew Name
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Hebrew Name
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Father's Hebrew Name
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Father's Hebrew Name
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What was the day of passing?
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mm/dd/yy
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What was the day of passing?
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mm/dd/yy
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Time of day? |
e.g. around 9:30 pm
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Time of day?
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e.g. around 9:30 pm |
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NOTIFICATION DETAILS
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Please send Yahrtzeit cards to the following people on the yahrtzeit:
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Name
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Full Address
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Name
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Full Address
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PAYMENT DETAILS
(Alternatively you may print this form and mail with a check to Chabad of Harford County, P.O. Box 393 Bel Air, MD 21015)
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Name on card |
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Amount to be charged |
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Card Number |
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Card Type |
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Exp. Date |
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CVV Code |
3 digits on back of card
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