Yizkor Book of Remembrance

Date

The TBE "Book of Remembrance" will be a special keepsake book that will be given out at Yom Kipper Services. It is a beautiful way for you to remember those family members that you have lost over the years.

The "Yizkor Book" donations are $18.00 for the first name and $9.00 for each additional name. Donations must be received no later than October 1, 2024

Name of person filling out this form*

First NameLast Name

Phone Number

Area CodePhone Number

Email*

example@example.com

Enter only ONE NAME PER BOX below. To add additional names, press "ADD ADDITIONAL NAME," after each entry.*

Select "Complete" after you entered ALL the names that will be printed in our Book of Remembrance?

The above name(s) are being remembered by?*

Please check spelling.

If you entered more than one name and would like any of the individual names to be combined on the same line in the Book of Remembrance,

For example

Sam Smith

Robin Smith

may be printed as Sam and Robin Smith or Mr. & Mrs. Sam Smith

enter your preference in the PRINT AS... box below.

PRINT AS ....

Total amount due:

How will you be paying?*

I will be paying by CheckI will be paying by Credit Card

Please consider paying an additional $3.00 to cover the bank fees incurred when using a credit card

Yes, I will be happy to pay an additional $3.00 to cover the bank feesNo thank you, charge my credit card the original amount

Total

Please pay the amount of ${totalAmount44}.00 and write "Yizkor Book" in the memo part of your check and mail it to:

Temple Beth El

5150 Peridia Blvd. East

Bradenton, FL 34203

PAYMENT IS DUE BY OCTOBER 1, 2024

Amount that will be charged to your credit card.

USDYizkor Book- 5120

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

2024/5785 Yizkor Book of Remembrance Name/Donation Form

List the name(s) of those being remembered below.