Yizkor Book
of Remembrance Donation
If you would like to have the name of a loved one listed
in Chevrei Tzedek’s Book of Remembrance, please
complete the form below. Note that the first three names are $18. Each name
after that is $10. Also, note that names listed together, i.e. Joe and Jane
Smith, are counted as TWO names. Print names clearly, as you
want them to appear in the book. To complete this form online and transmit it electronically,
go to https://spreadsheets.google.com/viewform?formkey=dHRlZ1BIRS05VTdlc0FwZTZSaEQ2V2c6MQ.
Names
listed below are being remembered by:
____________________________________________________________________
Name(s)
of people to be memorialized (use the reverse side, if you need extra space):
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Contact
person (in case clarification is needed):
____________________________________________________________________
Phone
Number: Day ______________________________ Evening _______________________________
Email
Address:
_________________________________________________________________________________________
Number of
listings:
1 name for $18.00 __________
2 names for $36.00 __________
Additional names @$10.00
per name __________
TOTAL ENCLOSED __________
Please
send this form with your check (separate from High Holiday tickets checks),
made out to “Chevrei Tzedek“ and marked “Yizkor” on the memo line, to:
Chevrei
Tzedek
3101