Chabad Jewish Center of S. Clemente Memorial Board
We are proud to present the Jerusalem Art Memorial Board.

Inscribe a loved one in our sacred space for posterity.

Each 2” x 10” plaque will have a bulb next to it that will illuminate the week of their Yahrtzeit.

The cost for inscription is $500. Early bird special is $360 until April 1.
For more information, assistance or to discuss a payment plan, please call 949-489-0723.
DONOR INFORMATION (individual ordering the plaque)
First name State
Last name Zip
Address Email
City Phone
I would like to dedicate plaque/s at $500* per name/plaque.
*$360 Early bird discount before April 1
Please inscribe the following name on the memorial tablet:
To purchase more than 2 plaques please email us or call the office at 949-489-0723.
Last Name Last Name
First Name First Name
Hebrew Name Hebrew Name
Father's Hebrew Name Father's Hebrew Name
Date of Passing Date of Passing
After dark? Yes No After dark? Yes No
(Alternatively you may print this form and mail with a check to Chabad of S. Clemente 1306 N. El Camino Real San Clemente, CA 92672.)
Paying by Credit Card Check
Payments can be made in 3 installments (if more time is needed, please call the office)
Name on card Amount to be charged
Card Number Card Type
Exp. Date CVV Code 3 digits on back of card