Temple Israel Memorial Plaque Order Form
Memorial plaques are a special way to remember a loved one in perpetuity. At Temple Israel, a small, engraved-brass memorial plaque is permanently mounted on the Yahrzeit Memorial Wall in our Hall of Remembrance outside the sanctuary, and a cast bronze memorial plaque is placed annually in the Deinard Chapel during the week of your loved one’s yahrzeit. The name of the departed and their Gregorian (English) date of death are inscribed on each plaque.
The cost for both plaques (the large bronze plaque and small brass plaque) is $1000 for each loved one you would like to remember.
I would like to:
Please select...
Order plaques for loved ones who have died
Pre-order plaques for those who are still living
Both
Pre-Order Memorial Plaque Information
You may also pre-order one or more plaques for persons still living at this time. Please enter the name of the person for whom the plaque is being pre-ordered below
as you would like it to appear on the plaque after their passing
. If you would like to pre-order additional plaques, please click the "add another response" link at the bottom right corner of this box.
First name:
(e.g. Margaret "Peggy")
Last name:
(e.g. Jones)
If you would like to add a middle name, maiden name and/or nickname, please enter them along with the first name into the "First name" field, using quotation marks for a nickname (e.g., Margaret "Peggy"). See example below.
The person named on this plaque is my
Please select...
wife
husband
spouse
partner
mother
father
parent
sister
brother
sibling
daughter
son
child
other
self
.
The person named on this plaque is my
.
Please specify your relationship to the person named on the plaque (e.g., aunt).
Pre-order relationship
Subtotal
Memorial Plaque Information
Please enter your loved one's information
as you would like it to appear on the plaque
. If you would like to order a plaque for another loved one who has passed, please click the "add another response" link at the bottom right corner of this box.
First name:
(e.g. Margaret "Peggy")
Last name:
(e.g. Jones)
If you would like to add a middle name, maiden name, and/or nickname, please enter them into the "First name" field along with the first name, using quotation marks for a nickname (e.g., Margaret "Peggy"). See example below.
The person named on this plaque was my
Please select...
wife
husband
spouse
partner
mother
father
parent
sister
brother
sibling
daughter
son
child
other
.
The person named on this plaque was my
.
Please specify your relationship to the person named on the plaque (e.g., aunt).
Post-order relationship
Gregorian (English) date of death:
Subtotal
Memorial plaque grand total
Purchaser Information
Purchaser first name:
Purchaser last name:
Purchaser email:
Purchaser phone:
Billing address:
Billing city:
Billing state:
Billing ZIP:
Payment Information
Amount to be charged:
$
Credit card number:
Exp. month:
MM
x
Exp. year:
YYYY
x
CVV:
Authnet_Hidden_Fields
Contact Information