Purchase a Memorial Plaque

PURCHASE A MEMORIAL PLAQUE

Memorial Plaques are a permanent way of remembering our loved ones. Memorial plaques are lit in the Sanctuary on the anniversary of the beloved's Yahrzeit and at the Memorial Service on Yom Kippur. Plaques are $500 and inscribed with the name of the deceased, their date of birth, and date of death. Please complete this form (3% FEE) or call the Temple office at (757) 625-4295 to order.
PURCHASER INFORMATION
Name of Purchaser:*

First NameLast Name
OST MemberNon-Member
E-mail:*
Phone Number:*

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
PLAQUE INFORMATION
Name of Deceased:*
TYPE EXACTLY AS YOU WISH THE NAME TO APPEAR ON PLAQUE
Date of Birth:*
Date Format: Month Date, Year
Date of Death:
Date Format: Month Date, Year
Notes/Additional Info:
$500
Total Amount for Memorial Plaque Purchase:
Will Send CheckCheck Already SentBill My Temple AccountBill My Credit Card* (ENTER CREDIT CARD INFORMATION BELOW)
Check #:*

Payment

USDOST Memorial Plaque

Payment Method
Credit	Express

PURCHASE A MEMORIAL PLAQUE