Yizkor Booklet Application and Donation Form PLEASE REMEMBER THE DEADLINE FOR APPLICATIONS IS: September 1, 2026 Full Name First Name Last Name Phone Number E-mail Please include my loved ones from last year’s Yizkor Book, Yes 1. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name 2. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name 3. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name 4. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name 5. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name 6. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name 7. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name 8. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name 9. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name 10. Name of Deceased First Name and Family Name (Hebrew and/or English) Deceased’s mother’s Hebrew First Name Space for More Names This year, we are also offering the following dedication options for your loved ones: Are you a Current Shul Member YesNot Yet Options whole page: $200 (includes unlimited names)1/2 Page: $100 (maximum 12 names)1/4 Page: $55 (maximum 5 names)1/8 Page: $30 (maximum 3 names )Each name: $10 (unlimited) Options whole page: $180 (includes unlimited names)1/2 Page: $80 (maximum 12 names)1/4 Page: $40 (maximum 5 names)1/8 Page: $20 (maximum 3 names )Each name: $8 (unlimited) How Many Names How Many Names Optional Donation $50$75$180$250$360 Total $0.00 Payment Credit Card Paypal Other Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearPaypal has been selected. Payment will take place on the next page.Please make the check payable to Chabad of Delray. Mark Yizkor Book on the memo line. Mail to: Chabad of Delray 6524 Sleepy Willow Way Delray Beach, FL 33484 Billing Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country I would like to receive news and updates by email Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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