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			<h1 class="article-header__title js-article-title js-page-title">Memorial Board</h1>
		
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      <p><span style="font-size: 14px; color: #a68c53">Dear Friends,</span></p>
<p><span style="font-size: 14px; color: #a68c53">We have recently received a beautiful new Yartzheit Memorial board in our Synagogue. This Board was donated by Mr. Jack Davis in memory of his beloved parents Nathan and Gertie Davis.</span></p>
<p><span style="font-size: 14px; color: #a68c53">The elegant memorial plaque board is a distinguished, reverent way of paying respect and tribute to the memories of our dear departed loved ones, showing as it does the prominent places they occupy in our place of worship and in our hearts.  </span></p>
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              <p><span style="font-size: 14px"><font color="#672B33"><strong><strong>Names inscribed on the plaque will have their Yahrtzeit observed in the following manner:</strong></strong></font></span></p>
<ul>
                <li><span style="font-size: 14px"><font color="#8E6B31">A letter will be mailed each year with a reminder of the day of the Yahrtzeit.</font></span></li>
<li><span style="font-size: 14px"><font color="#8E6B31">The memorial bulb will be lit during the week of the yahrtzeit and for all Yizkor Services.</font></span></li>
              </ul>
<p><span style="font-size: 14px"><font color="#8E6B31">The cost for inscription on a bronze nameplate is <strong>$360</strong>.</font></span></p>
<p><span style="font-size: 14px"><font color="#8E6B31">For more information or assistance, please call <strong><span class="skype_c2c_print_container skype_c2c notranslate">805-499-7051</span></strong></font></span></p>
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<p><span style="color: #9f833c"><span style="font-size: 14px; color: #9f833c"><span style="font-family: Arial; color: #9f833c">Sample Plaque </span></span> </span><img border="0" alt="tzi2.jpg" width="337" align="baseline" height="77" real_width="2183" real_height="496" src="https://w2.chabad.org/media/images/843/cxCk8436651.jpg"></p>
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            <td bgcolor="#632A31" height="15" colspan="5"><strong><font color="#ffffff" face="Tahoma">DONOR INFORMATION (individual ordering the plaque)</font></strong></td>
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            <td height="15" width="97"><span class="style1"><font color="#632A31" size="2" face="Tahoma">First name </font></span></td>
            <td height="15" width="154">
              <font color="#632A31" face="Tahoma"><input tabindex="1" class=" active" required="true" name="x_first_name" type="text"></font>
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            <td height="15" width="3"> </td>
            <td height="15" width="107"><span class="style1"><font color="#723508" size="2" face="Tahoma">
                  <font color="#723508" size="2" face="Tahoma">
                    <font color="#632A31" size="2" face="Tahoma">State</font>
                  </font>
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                        <font color="#723508" size="2" face="Tahoma">
                          <font color="#632A31" size="2" face="Tahoma">Last name</font>
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                      <font color="#632A31" size="1" face="Tahoma"><input tabindex="2" class=" active" required="true" name="x_last_name" type="text"></font>
                    </font>
                  </font></span></font>
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            <td height="15" width="3"> </td>
            <td height="15" width="107">
              <font color="#632A31" face="Tahoma">Zip</font>
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                  <font color="#723508" size="2" face="Tahoma">
                    <font color="#632A31" size="2" face="Tahoma">Address</font>
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            <td height="15" width="154"><span class="style1"><font size="1" face="Tahoma">
                  <font color="#632A31" size="1" face="Tahoma"><input tabindex="3" class=" active" required="true" name="x_address" type="text"></font>
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            <td height="15" width="3">
              <font color="#632A31"> </font>
            </td>
            <td height="15" width="107">
              <font color="#632A31" face="Tahoma">Email</font>
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            <td height="15" width="189">
              <font color="#632A31"><input tabindex="7" class=" active" required="false" name="x_email" type="text"></font>
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              <font color="#632A31" face="Tahoma">City</font>
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            <td height="15" width="3">
              <font color="#632A31"> </font>
            </td>
            <td height="15" width="107"><span class="style1"><font color="#632A31" size="2" face="Tahoma">Phone</font></span></td>
            <td height="15" width="189"><span class="style1"><font color="#632A31" size="1" face="Tahoma"><input tabindex="8" class=" active" required="true" name="x_phone" type="text"></font></span></td>
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            <td bgcolor="#ffffff" height="15" colspan="5"> </td>
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              <font color="#723508" face="Tahoma"><strong><font color="#ffffff">DEDICATION PLAQUE
<br></font></strong></font> <font color="#ffffff">
                <font face="Tahoma">I would like to dedicate</font>
              </font> <font color="#ffffff">
                <font face="Tahoma"> plaque/s at $360 per name/plaque.</font>
              </font>
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<tr>
            <td height="15" colspan="5">
              <font color="#723508">
                <font face="Tahoma">Please inscribe the following name on the memorial tablet:</font>
              </font>
            </td>
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<tr>
            <td bgcolor="#D9CCA4" height="15" colspan="2"><strong><font color="#723508">
                  <font color="#632A31" face="Tahoma">PLAQUE #1</font>
                </font></strong></td>
            <td height="15">
              <font color="#632A31"> </font>
            </td>
            <td bgcolor="#D9CCA4" height="15" colspan="2"><strong><font color="#723508">
                  <font color="#632A31" face="Tahoma">PLAQUE #2</font>
                </font></strong></td>
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            <td bgcolor="#FBF9F4" height="15">
              <font color="#723508">
                <font color="#632A31" face="Tahoma">Last Name</font>
              </font>
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            <td bgcolor="#FBF9F4" height="15">
              <font color="#632A31" size="1" face="Tahoma"><input tabindex="8" id="deceased_last" class=" active" required="true" name="deceased_last" type="text"></font>
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            <td height="15">
              <font color="#632A31"> </font>
            </td>
            <td bgcolor="#FBF9F4" height="15">
              <font color="#723508">
                <font color="#632A31" face="Tahoma">Last Name</font>
              </font>
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            <td bgcolor="#FBF9F4" height="15">
              <font color="#632A31" size="1" face="Tahoma"><input tabindex="9" id="deceased2_last" class=" active" required="false" name="deceased2_last" type="text"></font>
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              <font color="#723508">
                <font color="#632A31" face="Tahoma">First Name</font>
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            <td bgcolor="#FBF9F4" height="15">
              <font color="#632A31" size="1" face="Tahoma"><input tabindex="8" id="deceased_first" class=" active" required="true" name="deceased_first" type="text"></font>
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              <font color="#632A31"> </font>
            </td>
            <td bgcolor="#FBF9F4" height="15">
              <font color="#723508">
                <font color="#632A31" face="Tahoma">First Name</font>
              </font>
            </td>
            <td bgcolor="#FBF9F4" height="15">
              <font color="#632A31" size="1" face="Tahoma"><input tabindex="9" id="deceased2_first" class=" active" required="false" name="deceased2_first" type="text"></font>
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              <font color="#723508">
                <font color="#632A31" face="Tahoma">Hebrew Name</font>
              </font>
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            <td bgcolor="#FBF9F4" height="15">
              <font color="#632A31" size="1" face="Tahoma"><input tabindex="8" id="deceased_hebrew" class=" active" required="false" name="deceased_hebrew" type="text"></font>
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              <font color="#632A31"> </font>
            </td>
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              <font color="#723508">
                <font color="#632A31" face="Tahoma">Hebrew Name</font>
              </font>
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              <font color="#632A31" size="1" face="Tahoma"><input tabindex="9" id="deceased_hebrew" class=" active" required="false" name="deceased2_hebrew" type="text"></font>
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            <td bgcolor="#FBF9F4" height="15">
              <font color="#723508">
                <font color="#632A31" face="Tahoma">Father's Hebrew Name</font>
              </font>
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            <td bgcolor="#FBF9F4" height="15">
              <font color="#632A31" size="1" face="Tahoma"><input tabindex="8" id="deceased_fathers_hebrew" class=" active" required="false" name="deceased_fathers_hebrew" type="text"></font>
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            <td height="15">
              <font color="#632A31"> </font>
            </td>
            <td bgcolor="#FBF9F4" height="15">
              <font color="#723508">
                <font color="#632A31" face="Tahoma">Father's Hebrew Name</font>
              </font>
            </td>
            <td bgcolor="#FBF9F4" height="15">
              <font color="#632A31" size="1" face="Tahoma"><input tabindex="9" id="deceased_fathers_hebrew" class=" active" required="false" name="deceased2_fathers_hebrew" type="text"></font>
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              <font color="#723508">
                <font color="#632A31" face="Tahoma">Date of Passing</font>
              </font>
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            <td bgcolor="#FBF9F4" height="15">
              <font color="#632A31" size="1" face="Tahoma"><input tabindex="8" id="deceased_DOP" class=" active" required="false" name="deceased_DOP" type="text">
<br>
 mm/dd/yy</font>
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              <font color="#632A31"> </font>
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            <td bgcolor="#FBF9F4" height="15">
              <font color="#723508">
                <font color="#632A31" face="Tahoma">Date of Passing</font>
              </font>
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<br>
 mm/dd/yy</font>
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                <font color="#632A31" face="Tahoma">After dark?</font>
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                <font color="#632A31" face="Tahoma"><input tabindex="8" type="radio" name="Deceased_after_dark" value="Yes">Yes   <input tabindex="8" type="radio" name="Deceased_after_dark" value="No">No</font>
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              <font color="#723508">
                <font color="#632A31" face="Tahoma">After dark?</font>
              </font>
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            <td bgcolor="#FBF9F4" height="15">
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                  <font color="#723508">
                    <font color="#632A31" face="Tahoma"><input tabindex="9" type="radio" name="Deceased2_after_dark" value="Yes">Yes   <input tabindex="9" type="radio" name="Deceased2_after_dark" value="No">No</font>
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              <font color="#ffffff" face="Tahoma"><strong>NOTIFICATION DETAILS</strong></font>
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              <font color="#723508">
                <font color="#632A31" face="Tahoma">Please send Yahrtzeit cards to the following people on the yahrtzeit:</font>
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              <font color="#632A31"> </font>
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<tr>
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              <font color="#ffffff" face="Tahoma"><strong>PAYMENT DETAILS
<br></strong> <span style="font-size: 10px">(Alternatively you may print this form and mail with a check to Chabad of Newbury Park, 350 Via las Brisas #110 )</span></font>
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            </td>
            <td height="15" width="107"><span class="style1"><font color="#632A31" size="2" face="Tahoma">Amount to be charged</font></span></td>
            <td height="15" width="189">
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<tr>
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            <td height="15" width="154">
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            <td height="15" width="3">
              <font color="#632A31"> </font>
            </td>
            <td height="15" width="107"><span class="style1"><font color="#632A31" size="2" face="Tahoma">Card Type</font></span></td>
            <td height="15" width="189"><input tabindex="19" class=" active" required="true" name="x_card_type" type="text"> </td>
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<tr>
            <td height="15" width="97"><span class="style1"><font color="#632A31" size="2" face="Tahoma">Exp. Date</font></span></td>
            <td height="15" width="154">
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            <td height="15" width="3">
              <font color="#632A31"> </font>
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            <td height="15" width="107"><span class="style1"><font color="#632A31" size="2" face="Tahoma">CVV Code</font></span></td>
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