Sanctuary Memorial Lights Plaque Request Form

Calendar

As long as we live, they too will live,
For they are now a part of us
As we remember them.

* Yes, I would like to purchase a Sanctuary Memorial Lights Plaque.

Yes, I would like to purchase a Sanctuary Memorial Lights Plaque.The cost of the Sanctuary Memorial Lights Plaque is $250. Payment in full is required for your order to be processed. A copy of the plaque proof PDF will be provided for your review and approval before the order is placed with the manufacturer. It takes about 6 weeks for plaques to be completed and mailed to the synagogue.

Please fill out this form once per order. You may submit this form as many times as you wish.

Information About the Departed

English Name of Departed (as you want it engraved on the plaque)

Hebrew Name of Departed (Hebrew characters)

Hebrew Name of Departed (English characters)

Father's Hebrew Name (Hebrew characters)

Father's Hebrew Name (English characters)

Mother's Hebrew Name (Hebrew characters)

Mother's Hebrew Name (English characters)

Date of Death

Check here if after sunset

Purchaser Information

Purchaser's Name

Relationship to Departed

Address

City

State

Zip Code

Telephone

Date of Request

Thu, November 21 2024 20 Cheshvan 5785

Temple Israel of Portsmouth 200 State Street, Portsmouth, NH 03801 603-436-5301 templeoffice@templeisraelnh.org

Privacy Settings | Privacy Policy | Member Terms