YAHRZEIT MEMORIAL BOARD PLAQUE INFORMATION
Mail this completed form and your check for $350 (if you have not already done so).
Please write "Yahrzeit Plaque" on your check.
Send to: CONGREGATION B’NAI ZION • 750 UNITED STREET • KEY WEST, FLORIDA 33040

Name_______________________________________________________________________________________________________________

 

 

Address____________________________________________________________________________________________________________

 

 

Telephone_____________________________________ Email______________________________________________________________

If you do not have responses to the information requests listed below, please write “Lack Sufficient Information.”
We will attempt to complete the application.
We will not order the plaques until You have had a final opportunity to review the lettering
that will be engraved on the individual plaques ordered.
The plaque will have the Hebrew name of the decedent on the First line and his English name on the Second line.
The secular date of death will be in the lower Left hand corner and the Hebrew date of death will be in the lower Right corner.

Any Comments

______________________________________________________________________________________________________________

  Name of Decedent in English as you want it to appear on the Plaque:

 

 

______________________________________________________________________________________________________________

 

Secular date of Death

______________________________________________________________________after Sunset Yes________ No______

 

 

  First Names of Decedent and his/her Father in English or in Hebrew (phonetically/transliteration):

 

Decedent: _______________________________________________ Father:_______________________________________________

 

If unknown, B’nai Zion will meet with you: re: the names to be inscribed.

Was the Decedent a Levi (yes/no) or a Cohen (yes / no?)

 

__________________________________________________________________________________________________________________

CBZ members can purchase Yahrzeit plaques for their loved ones but non-members can only purchase Yahrzeit plaques
for loved ones who were members of CBZ at the time of their deaths.

Yahrzeit plaques cannot be purchased for any living person even if done in anticipation of death.