Memorial Plaque & Golden Book of Remembrance Order Form

in the name of (please print exactly how you wish the name to be memorialized:
Date of death (English):
Date of death (Hebrew)
Please send yearly notices of yahrzeit observance to the following addresses. Please include relationship to the deceased:

The cost of a memorial plaque is $600 and a listing in the Golden Book of Remembrance is $200 per name.  Please make checks payable to B'nai Jeshurun Congregation and mail to the attention of Diane Dronzek at 27501 Fairmount Blvd., Pepper Pike, OH  44124.