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Yahrzeit Plaque Order Form

Please log in to your Adat Shalom account for the best user experience and to easily auto-populate your information. If you are not signed in or do not have an account simply proceed to the form below. You must be logged in to your Adat Shalom account to pay by check or ACH.

Contact Information for Individual Placing the Order
Yahrzeit Information for Your Loved One:
Please make sure you correctly indicate whether the death was before or after sunset,. This will allow our yahrzeit system to correctly translate the date to the Hebrew Calendar.
Please make sure you correctly indicate whether the death was before or after sunset,. This will allow our yahrzeit system to correctly translate the date to the Hebrew Calendar.
Please make sure you correctly indicate whether the death was before or after sunset,. This will allow our yahrzeit system to correctly translate the date to the Hebrew Calendar.
Please make sure you correctly indicate whether the death was before or after sunset,. This will allow our yahrzeit system to correctly translate the date to the Hebrew Calendar.
The Yahrzeit plaque artwork will be sent to you for final approval to confirm correct spelling and dates before it's installed on our Memorial Board.
*You must be logged in to your Adat Shalom account to pay by check or ACH*
Check: Once logged in, on the next page select Bill to My Account and then mail or bring a check to the office
Credit Card: On the next page select Credit Card and then enter your credit card information
ACH: On the next page select ACH and then enter your banking information as prompted
Wed, September 3 2025 10 Elul 5785