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The Salzbank Family Memorial Board
Names inscribed on the plaque will have their Yahrtzeit observed in the following manner:
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A card will be mailed each year with a reminder of the day of the Yahrtzeit.
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If there is no family member present on the Yahrtzeit day to say the “Kaddish”, it will be said for you.
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The memorial bulb will be lit during the month of the yahrtzeit and during all Yizkor days.
The initial cost for inscription on a bronze plaque is $1,000.00. Each year thereafter, a contribution of any size will be accepted on the Yahrtzeit day. For a memorial plaque application, please call
516-767-8672
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DONOR INFORMATION (individual ordering the plaque) |
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First name |
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State
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Last name
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Zip
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Address
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Email
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City
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Phone |
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DEDICATION PLAQUE
I would like to dedicate
plaque/s at $1,000.00 per name/plaque.
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Please inscribe the following name on the memorial tablet:
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PLAQUE #1
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PLAQUE #2
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Last Name
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Last Name
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First Name
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First Name
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Hebrew Name
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Hebrew Name
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Father's Hebrew Name
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Father's Hebrew Name
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Date of Passing
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mm/dd/yy
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Date of Passing
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mm/dd/yy
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After dark?
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Yes No
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After dark?
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Yes No
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NOTIFICATION DETAILS
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Please send Yahrtzeit cards to the following people on the yahrtzeit:
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Name
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Full Address
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Name
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Full Address
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PAYMENT DETAILS
(Alternatively you may print this form and mail with a check to Chabad of Port Washington, 80 Shore Road, Port Washington NY 11050.)
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Name on card |
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Amount to be charged TODAY |
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Card Number |
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Card Type |
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Exp. Date |
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CVV Code |
3 digits on back of card
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