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Sh’loshim and Yahrzeit Memorial Form
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Indicates required field
Contact information:
Name
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Phone Number
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Email
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Name of departed:
English name
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Hebrew name
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If known, include the Hebrew name and mother’s name – “so-and-so, the son/daughter of mother.”
Relationship (father, mother, etc.)
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Date/time of passing
Month
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January
February
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December
Day
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Year (xxxx)
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Hour
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Minute
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Time of day
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am
pm
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