Memorial Plaque Information:

Name of Donor:
In Memory of:
Hebrew name and fathers Hebrew name:
Non Hebrew name:
English Date and Year:
Hebrew Date and Year:

If more than one Plaque is needed? Please request a second form.

Cost is $360.00 

Payment type:      
CheckCredit Card#

Please add this amount to the charge as a general donation to Chabad.

Amount enclosed:

If you are sending a payment by mail - please make the payment to: Chabad of N. Broward Beaches Inc. C/O Rabbi Tzvi Dechter
2025 East Sample Road, Lighthouse Point, FL 33064 

Your contribution will go a long way to help establish a stronger bond of identity and awareness throughout our Jewish community. Our sages teach us that a soul never ceases to exist. Once it departs from the physical body it may be even closer to its friends and loved ones since it is not bound by physical restrictions.

Please acknowledge my gift to this address: