Yizkor Memorial Submission Form

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Members-- please sign in first using the button in the upper right corner, then fill in the form boxes below for each loved one whose name you wish to have recited during the Yizkor Memorial Service on Yom Kippur Afternoon.
Nonmembers-- you may also use this form for name submissions.

Note: If you have more than four names, you may submit the form more than once.

Name of Deceased

Relationship

Date of Death

Name of Deceased

Relationship

Date of Death

Name of Deceased

Relationship

Date of Death

Name of Deceased

Relationship

Date of Death

* Your First Name

* Your Last Name

* Your Email confirmation address

Street Address

City

State

Zipcode

Phone (optional)

Voluntary Donation

In honor of the memory of my loved ones I would like to make a donation in the amount I enter above.

Payment Options

I will mail a check to Sukkat Shalom, 1001 Central Ave., Wilmette, IL 60091I would like to charge the amount above to my member account.If you choose to make a contribution, please select one payment option. OR, you may simply click the "Submit" button to include the names on the Yizkor reading list. Thank you.

Thank you very much. You will receive an email confirmation. Questions or changes? Contact Andrew Schultz, Executive Director, 847.251.2675; aschultz@sukkatshalom.org.

Sat, February 16 2019
11 Adar I 5779