Yahrzeit Information

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out the below information if you would like to receive reminders on the Hebrew anniversary of your loved one's death. If you are already receiving reminders for a loved one, there is no need to fill this out again for that person. If you have received a reminder in the past year that had an inaccuracy, please fill out the below and put a note at the bottom so that we can update our database.

Email *

BJ member first name *

BJ member last name *

BJ member email address *

BJ member phone number

Deceased first name *

Deceased last name *

Relationship type (ie. the deceased is my mother/father/sister/etc) *

Date of death *

YYYY

Time of death (approximate, if known) *

Anything you would like to note or ask?

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of B'nai Jeshurun.

Does this form look suspicious? Report

Forms