Chair Plaques - Temple Har Zion

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Your Information
(This will be pre-filled if you are a member and have logged in)

* First Name

* Last Name

And

First Name

Last Name (if different)

* Street Address

Suite, Apt, Unit

City or Town

Province

Postal Code

* Email

Mobile

Home Phone

How many plaques do you wish to order?

OneTwoThree

Plaque Information
You have a choice of up to three lines

Line 1

Line 2

Line 3

Do you wish us to send a tribute card?

Please Select OneYesNo

To whom should we send a tribute card?

Are they a member of Temple Har Zion?

Please Select OneYesNo

* Address

Address Line 2

* City

* Province

* Postal Code

Plaque #2

Line 1

Line 2

Line 3

Do you wish us to send a tribute card?

Please Select OneYesNo

To whom should we send a tribute card?

Are they a member of Temple Har Zion?

Please Select OneYesNo

* Address

Address Line 2

* City

* Province

* Postal Code

Plaque #3

Line 1

Line 2

Line 3

Do you wish us to send a tribute card?

Please Select OneYesNo

To whom should we send a tribute card?

Are they a member of Temple Har Zion?

Please Select OneYesNo

* Address

Address Line 2

* City

* Province

* Postal Code

(Optional) Comments

Total donation for today