Chapel Plaque Order Form

The maximum amount of lines for the inscription are four.

The minimum amount of lines for the inscription are three. Line 3 must contain birth and death information or Yarzeit.

This plaque can only be inscribed in tribute to one individual.

 

Line 1:

                                              Dedication
       (for example: "Beloved mother, father, brother, sister)
Line 2:

                                       Name of Deceased
Line 3:

mm / dd / yyyy
                        (Birth Date)
 

mm / dd / yyyy  
                      (Date of Death)

Use Dates above or use Yarzeit below

 
                                                Yarzeit
Line 4:

                                            (Optional)