Burial Plot Inquiry Form

Contact Information:

Name (First and Last)

Phone Number

Email Address

Are you a member of Temple Israel?

Do you have family members who are buried or have plots reserved in Temple Israel's Cemetery

What section are you interested in?

How many plots are you interested in reserving?

Non-Member Rate ......... $4,000
Member Rate ......... $2,000

Reservee Information:

Name of Reservee (First and Last)

Hebrew Name

Transliterated Hebrew Name

If unsure of Hebrew

Date of Birth

After Sunset?

(This helps us determine the Hebrew date)

Designation

Relation to Contact Person

Family Information:

Parent 1 Name (First and Last)

Parent 1 Hebrew Name (if known)

Transliterated Hebrew Name

If unsure of Hebrew

Designation

Parent 2 Name (First and Last)

Parent 2 Hebrew Name (if known)

Transliterated Hebrew Name

If unsure of Hebrew

Designation

Thu, April 25 2024 17 Nisan 5784