Dedicate a Plaque A memorial plaque dedication is a distinguished and eternal way of paying respect and tribute to the memories of our dear departed loved ones; showing, as it does, the prominent places they occupy in our community and in our hearts. This artistic masterpiece, being created by world renowned artist Michoel Muchnick, is a 3D hand-painted mural of "Jerusalem of Gold". Each plaque will be engraved with your loved one's English and Hebrew name and date of passing. Each year, during the month of the Yahrtzeit, the light at your loved one's name will be lit. A Yahrtzeit reminder will be sent to the family each year. If there is no family member present, Kaddish will be recited on the Shabbos of the Yahrtzeit - when possible. Any Jewish person can be added to the memorial board. No membership or prior affiliation is required to place a plaque in memory of your loved ones. The cost of plaque with inscription is $540. You can also reserve space to be installed at a later date for the current rate. DONOR INFORMATION Full Name* Title First Name Last Name E-mail* Phone Number* Area Code Phone Number DEDICATION PLAQUE$540 donation per name Number of plaques $540 per plaque PLAQUE INFOFill in all the requested info. If you're ordering more than one plaque, you'll write the info in the boxes lower down (below plaque #1). Name As you'd like it to appear on the plaque Hebrew Name You can write it in English text, we will convert it to Hebrew Father's Hebrew Name You can write it in English text, we will convert it to Hebrew Date/time of passing We'll calculate the Hebrew Yahrtzeit. Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM Relationship to Donor (Optional) BOARD DEDICATIONThere are still 2 (out of 3) spaces available to dedicate the Memorial Board. Please contact me with more information about dedicating the beautiful new Memorial Board (Optional) EMPTY PLAQUE RESERVATIONIf you want family members to be listed together. And to receive current rate. Number of plaque spot(s)to reserve: Plaques will remain empty until you send the info. (Optional) COMMENTS/QUESTIONS Comments: Use this space for additional information/details. OPTIONAL DONATION Donation to ensure Jewish continuity - in memory of your loved one(s). $36$54$100$180$540$1000$1800$3600 PAYMENT DETAILS Total $0.00 I would like to pay today:Full amount$90.00 minimum$ Yes, I'd like to donate the cost of processing this transaction by adding 3% Partial Amounts: Indicate how to proceed with charging Please make sure to complete the payment in full within a period of 6 months. Payment method Credit Card Paypal eCheck Cash/Check Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2024202520262027202820292030203120322033 Expiration YearPaypal has been selected. Payment will take place on the next page. 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