Memorial Plaque & Brick Order Form

The High Holy Days is a time of reflection and also a good time to honor parents, children, or other family members, or mark a special occasion such as a wedding, graduation, or b’nai mitzvah. Consider purchasing a commemorative brick that will be displayed at our building’s entrance for years to come.

During the High Holy Days, we also remember our loved ones that are no longer with us. The Memorial Board Plaque or brick is a special and meaningful way to remember our loved ones.

* Please select one or more options

Memorial Board Plaque ($500)Brick with Text Only ($100)Brick with Torah Image ($136)Brick with Jewish Star Image ($136)

* First Name

* Last Name

* Email Address

* Phone Number

* Address

* City

* State

* Zip Code

* Payment Type

Please note there is a 3% service charge for using a credit card

Please only complete if paying by credit card online:

Credit Card Number

Please note there is a 3% service charge for using a credit card

Expiration Date

CVV

Please only complete if you would like a Memorial Plaque on the Memorial Board in the Sanctuary:

English Name

English Date of Death

Hebrew Date of Death

Relationship to Member

Placement on Memorial Board

Please note: We will accommodate requests when possible. Members should feel free to come in and look at the board.

Please only complete if you are purchasing a brick:

The following is for illustrative purposes only. Please use the grids as a guide for how many letters to enter, including spaces. One grid box is a letter or space.

If there is NO clipart, it's a maximum of 20 characters per line
If you are adding an image (Jewish Star or Torah), it is a maximum of 15 characters per line

Please note that your text will show exactly as you enter below. i.e. if you want a capital letter, please enter as such. Please proofread your entry carefully.

Brick 1: Enter brick text as per the grid (limit text to 15 without image or 20 with image, including spaces)

Brick 2: Enter brick text as per the grid (limit text to 15 without image or 20 with image, including spaces)

Brick 3: Enter brick text as per the grid (limit text to 15 without image or 20 with image, including spaces)

Brick 4: Enter brick text as per the grid (limit text to 15 without image or 20 with image, including spaces)

Order Total (plus 3% if paid by credit card)

Please note, an additional 3% service charge will be added to your Order Total if you are paying by credit card.

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Thank you for your order! Please be patient as your order may take some time. We will be in touch if we have any questions! Please also feel free to call/email the office with any questions: 516-944-7202 or info@portjewishcenter.org

Wed, April 30 2025 2 Iyar 5785