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 $750
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
 
DEDICATION PLAQUE
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.
PLAQUE #1   PLAQUE #2
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
 
PAYMENT DETAILS
(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