Memorial Wall Tribute Brick Order Form - Form

All Congregation Or Hadash members are eligible to purchase Memorial Tribute Bricks for their deceased loved ones. These bricks are uniquely and beautifully presented on our Memorial Wall in the sanctuary. Purchasing a Memorial Tribute Brick is a tangible way to visually remember your loved one(s) from generation-to-generation, and support Or Hadash at the same time. The cost of a single Memorial Tribute Brick is $756.

Please take a look at our Memorial Wall to decide what brick placement is best for you and your family; selection is by row and column number. There are three color choices in shades of blue - deep, medium, and light blue. The bricks are aligned consecutively across the board. If after purchase of a brick, you decide on a different location you can change as long as the new location is the same color and has not been reserved by another member. The memorial brick is inscribed with the deceased's name, Hebrew translation of the name, and the date of death in English and Hebrew.

Upon completion of this form, Rabbi will review the information for accuracy prior to ordering the brick.

Purchaser Information

First Name

* Last Name

* Email Address

* How many purchases with this order?

Please Select OneOneTwoThree

Tribute Brick Detail

* English name to display on the brick: First Name and Middle and/or Maiden Name if desired.

* English last name to display on the brick.

Hebrew name to display on the brick: Including Parents' Names (i.e. Isaac ben Avraham and Sarah)

* English DOD (MM/DD/Year)

Was death before/after sunset

Hebrew date of death (i.e., 10 Av 5777)

Second Brick

* #2: English name to display on the brick: First Name and Middle and/or Maiden Name if desired.

* #2: English last name to display on the brick.

#2: Hebrew name to display on the brick: Including Parents' Names (i.e. Isaac ben Avraham and Sarah)

* #2: English DOD (MM/DD/Year)

#2: Was death before/after sunset

#2: Hebrew date of death (i.e., 10 Av 5777)

Third Brick

* #3: English name to display on the brick: First Name and Middle and/or Maiden Name if desired.

* #3: English last name to display on the brick.

#3: Hebrew name to display on the brick: Including Parents' Names (i.e. Isaac ben Avraham and Sarah)

* #3: English DOD (MM/DD/Year)

#3: Was death before/after sunset

#3: Hebrew date of death (i.e., 10 Av 5777)

First Brick Placement and Color Choice

If you do not know which row and/or column you want for your loved one's memorial brick, it can be determined later in the process.

Requested column number

Requested row number

Second Brick Placement and Color Choice

If you do not know which row and/or column you want for your loved one's memorial brick, it can be determined later in the process.

#2: Requested column number

#2: Requested row number

Third Brick Placement and Color Choice

If you do not know which row and/or column you want for your loved one's memorial brick, it can be determined later in the process.

#3: Requested column number

#3: Requested row number

Tribute Brick Purchase and Payment Options

The cost of each memorial brick is $756. After you click 'submit' button below, you will have the option to pay-in-full or split the payment.

* Total Tribute Bricks included in this invoice?

Total Amount Due