Book of Memory Form 2019 / 5780


If you wish your loved ones' names to be included in the Yom Kippur Book of Memory, please complete this form. Names from last year will automatically be included, so please submit only new names to be added. Names MUST be submitted online by August 19. After the deadline, we may not be able to include names in the book. It is customary, although not required, to make a donation in memory of departed loved ones.

To donate by check, print this form and mail form and check to:
The Community Synagogue
160 Middle Neck Road
Port Washington NY 11050.

To donate By Credit Card
(enter credit card information below)
Please bill my/our synagogue account
Please enter your contribution amount.
Book of Memory Information
Please check here if the listing is the same as last year.
The Book of Memory is now open, donations are being accepted. Please list only names of those who have recently departed or were not listed last year. Write the names as you wish for them to appear, only if this is a new listing. Names already in the book previously, remain the same.
Remembered by
Your name(s) should be typed exactly as you want the listing to appear.
(Example: David & Lisa Gold, or The Gold Family, or Lisa Gold)
Your Information
This is the address where your credit card statements are mailed.
A receipt will be e-mailed to this address.
*Only enter your credit card information if you are making a credit card donation.*
Your Payment Information

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