Young Israel of Northridge Orthodox Synagogue
Family Yahrzeit Record Form
We would like to maintain Yahrzeit records for your family. Please give us the following information. Additional names can be listed on the back of this form. All those with Permanent Memorial Plaques in the sanctuary are automatically notified each year. Names are usually read at the Shabbat Mincha service the week prior to the yahrzeit date, unless that Shabbat is a holiday or Rosh Hodesh. Reminder letters will be sent out the month before the Yahrzeit date.
Your information:

Last Name

Husband First Name

Wife First Name
   Relationship to:
Name of Deceased
 Husband,   Wife

Hebrew Name (son/daughter of father's Hebrew name - English transliteration)

English Date of Death
(MM/DD/YYYY)

Husband First Name

Wife First Name

   Relationship to:
Name of Deceased
 Husband,   Wife

Hebrew Name (son/daughter of father's Hebrew name - English transliteration)

English Date of Death
(MM/DD/YYYY)

Husband First Name

Wife First Name

   Relationship to:
Name of Deceased
 Husband,   Wife

Hebrew Name (son/daughter of father's Hebrew name - English transliteration)

English Date of Death
(MM/DD/YYYY)

Husband First Name

Wife First Name

   Relationship to:
Name of Deceased
 Husband,   Wife

Hebrew Name (son/daughter of father's Hebrew name - English transliteration)

English Date of Death
(MM/DD/YYYY)

Husband First Name

Wife First Name

Printing Instructions: Type in your information on screen, use your browser menu "File > Print" to print the form.

Young Israel of Northridge. 17511 Devonshire Street, Northridge, CA 91325
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