Purchase a Memorial Plaque

PURCHASE A MEMORIAL PLAQUE

Memorial Plaques are a permanent way to remember our loved ones. These memorial plaques are lit on the anniversary of a loved one's Yahrzeit and at the Yizkor Service on Yom Kippur, Shemini Atzeret, Passover and Shavuot. The plaques, which cost $500, are inscribed with the name of your loved one as well as the date of birth and death.

Please note there is a 3% surcharge that will be applied to your order for online processing fees and this form is for submission for ONE memorial plaque. Please visit our Memorial Page to start the process again for any additional plaques you would like to purchase.
PURCHASER INFORMATION
Name of Purchaser: *

First Name Last Name
E-mail: *
Phone Number: *

Area Code Phone Number
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
PLAQUE INFORMATION
Name of Deceased (As you want it to appear on the plaque)
Type exactly as you wish the name to appear on the plaque
Date of Birth (Specify date format desired):
Date Formats: 1/2/YYYY or January 2, YYYY
Date of Death (Specify date format desired):
Date Formats: 1/2/YYYY or January 2, YYYY (Will be converted to Hebrew Date)
Time of Day *

AM PM
Memorial Plaque Amount (Please click radial button): *

$500
Total Amount for Memorial Plaque Purchase:
How would you like to pay for your donation? *

Bill My Temple Account Bill My Credit Card* (ENTER CREDIT CARD INFORMATION BELOW)

Payment

USD Memorial Plaque Donation

Payment Method