SUSPENDED FORM

Congregant's Name

Email

Address

Yahrzeit Plaque in Memory Of (English Name)

Hebrew Name

Ben/Bat

Kohane or Levy (Men Only)

Kohane Levy

English Date of Death

Time of Death

Before or After Sunset

Before Sunset After Sunset

Relation to Congregant

It is the responsibility of the congregant to provide and verify all submitted information. Re-orders due to incorrect information will be the responsibility of the congregant.

I agree to the terms of service.

Price $500
Please mail your check to Congregation B'nai Torah, 700 Mt. Vernon Hwy, Sandy Springs, GA 30328 Attention: Sarah Woelz/Yahrzeit Plaque

Verification