Individuals are welcome to honor their deceased loved ones by creating a virtual memorial plaque. Plaques are $75 each. Buying a plaque will automatically add you to the yearly yahrzeit reminder mailing list so there is no need to additionally fill out that form on this website. To get started, sign up below. Your Information Name Prefix - None -Mrs.Ms.Mr.Dr.RabbiCantorHazzan First Name * Last Name * Street Address * City * Postal Code * Country * AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo, Republic Of TheCongo, The Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSerbia and MontenegroSeychellesSierra LeoneSingaporeSint Maarten (Dutch Part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe State/Province * Email * Phone Number * Click Here to Fill Out Deceased's Information Is Deceased Yes Name Prefix - None -Mrs.Ms.Mr.Dr.RabbiCantorHazzan First Name * Middle Name Last Name * Former Last Name (if applicable) Nickname How you would like English name to appear on plaque? * Hebrew Name (will appear on plaque) May type in English or Hebrew characters. Examples: Shmuel, shmuel ben Yaakov and Sara, Shmuel ben Yaakov or Shmuel Schwartz Mother's Name (English and/or Hebrew) Father's Name (English and/or Hebrew) Additional Parent's Name (English and/or Hebrew) Deceased is Holocaust Survivor Yes No Deceased Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Please indicate month, day, and year. The date of death is not required, however a date of observance is needed if you would like your loved one's plaque to appear on the website plaque scroll sometime during the year. Death Date Before Sunset * Yes No This is a required field. If you don't know the time of death, please choose "yes." Birth Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Please indicate month, day and year. City of birth State/Province of birth Country of birth Gender - None -FemaleMale Deceased is my: Parent Spouse Sibling Aunt/Uncle Great Aunt/Uncle Niece/Nephew Cousin Grandparent Great Grandparent Grandchild Step-parent Child Step-child Ancestor Partner Friend Mourner observes the English date Yes No Cemetery Name Cemetery City Cemetery State/Province Cemetery Country Cemetery Burial Information (plot #, etc.) Deceased's Synagogue Affiliation Deceased's Synagogue Location Image of Deceased Files must be less than 10 MB.Allowed file types: gif jpg png. Biography of Deceased More information about text formats Text format Full HTML This text format will be used to filter your html. You can not change this. Full HTMLWeb page addresses and e-mail addresses turn into links automatically.Lines and paragraphs break automatically.Filtered HTMLWeb page addresses and e-mail addresses turn into links automatically.Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>Lines and paragraphs break automatically.Plain textNo HTML tags allowed.Web page addresses and e-mail addresses turn into links automatically.Lines and paragraphs break automatically.