High Holy Days 2020 Order Form – Houston Congregation for Reform Judaism

In this order form you will be able to provide information for the video of remembrance, purchase a memorial plaque and order jars of honey from HCRJ's very own beehive.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Would you like to include a name(s) in the Yom Kippur video of remembrance.*
- yes
- no
In lieu of a book of remembrance, this year HCRJ will be creating a video of remembrance to memorialize your loved ones who have passed. The video will be made available on Yom Kippur day and will be accessible thereafter. If you wish, you may also upload a photo of the person you are memorializing to be included in the video. The cost is $18 per name.
How many names would you like included in the video of remembrance?
Price: $18.00 Quantity:
Names for Video of Remembrance
Name of loved one Date of Birth Date of Death

To add multiple names, click on the + sign.
If you wish to have a picture(s) included in the video of remembrance, please upload a photo of the person to be memorialized here. Photos should be saved as .jpg or .png and with the persons name as the title of the file.
Drop files here or
Would you like to purchase a plaque to remember your loved one on the Memorial Wall?
- Yes
- No
How many memorial plaques would you like to order?
Price: $500.00 Quantity:
Details for memorial plaque
Name as it should appear on the plaque Date of Birth Date of Death

To order multiple plaques, click on the + sign.
Honey from the HCRJ bee hive is now for sale. Each 8 ounce jar is $18 and 100% of the proceeds will go to support HCRJ. Would you like to order honey?
- Yes
- No
How many jars of honey would you like to purchase?
Price: $18.00 Quantity:
If you would like to make an additional donation to support HCRJ, please include the amount here.
Total
$0.00

Name of loved one	Date of Birth	Date of Death

Name as it should appear on the plaque	Date of Birth	Date of Death