YIZKOR FOR YOUR LOVED ONES WHETHER YOU'LL BE AT SHUL FOR YIZKOR, OR YOU DO IT FROM HOME, YOUR LOVED ONES SHOULD BE MENTIONED TOGETHER WITH THE COMMUNITY, BEFORE YIZKOR BEGINS. A REQUESTED DONATION OF $10 (OR MORE) PER NAME CAN BE ADDED BELOW. ("CHABAD CLUB" MEMBERS ARE FREE OF CHARGE.) If you already entered your loved ones name at the High Holidays, there's no need to fill out this form, they will be mentioned. _________________________ Click here to learn more about the Chabad Club. YAHRZEIT INFORMATION Please use the following list: Name: Date: Relationship: Civil Hebrew Mother's Hebrew Last Month(xx) Day(xx) Year(xxxx) i.e. mother/father etc. PAYMENT INFORMATION Please use box below for any comments or notes: Last Name: First Name: Address: State: Zip: Email: Phone: Payment Method: Credit card Check by mail CC Type: Select Visa Mastercard American Express Credit Card #: Expiration Date: Select 01-January 02-February 03-March 04-April 05-May 06-June 07-July 08-August 09-September 10-October 11-November 12-December Select 2020 2021 2022 2023 2024 2025 2026 2027 CVV Total Amount due: PLEASE NOTE: ⇒ You must write the total due in the 'Amount box' above. ⇒ Members of the "Chabad Club" write: "CC" in the 'Amount box' above. ⇒ Become a Member of the "Chabad Club" by donating here or Partner here. This page uses 128 bit SSL encryption to keep your data secure.