The Eli Aran, A"H - Memorial Wall Order Form Please engrave a memorial plaque to be placed on the memorial wall in memory of my late Mother Father Grandmother Grandfather Brother Sister Other Choose One . I understand that The JCC - Chabad LIC will be sure to illuminate the light during the week of the yahrtzeit (anniversary of passing). The JCC - Chabad LIC will notify you of the upcoming yahrtzeit. Price per plaque is $500.00 Inscription to be engraved as follows: Line 1 Line 2 Line 3 Line 4 Purchased by: Name Last Name Address City, State, Zip Phone Number Method of Payment: Credit Card or Please bill me at the above address Credit Card Number Expir. Date Name on card Total to be charged to card Billing Address Billing Zip Security Code * For multiple orders, please reuse this form. This page uses 128 bit SSL encryption to keep your data secure.
