Yizkor Name Collection

All information entered is private to Congregation Or Ami and is never shared or made public outside of the congregation.
Your First Name(*)
"First Name" is required

Your Last Name(*)
"Last Name" is required

Email(*)
"Email" is required

Please list the names of your departed loved ones and their relationship to you and your family members as you would like them presented in the Yizkor book; i.e., Mother of Adam, Grandmother of Issac. Also please indicate names of loved ones who have passed away within the last year.
Name of Relative(*)
Invalid Input

Relationship(*)
Invalid Input

Did this person pass away in the past year?
Invalid Input

Name of Relative
Invalid Input

Relationship
Invalid Input

Did this person pass away in the past year?
Invalid Input

Name of Relative
Invalid Input

Relationship
Invalid Input

Did this person pass away in the past year?
Invalid Input

Name of Relative
Invalid Input

Relationship
Invalid Input

Did this person pass away in the past year?
Invalid Input

SUGGESTED DONATION AMT : 1 name $18; more than 1 $36
Donation Amt $
You must enter numbers representing the total amount you wish to donate

Enter a voluntary donation amount.

Donation
"Fund" is required