CLICK HERE TO SEE A SAMPLE OF THE YIZKOR BOOKLET Contact Information Full Name* First Name Last Name E-mail* Cell Number Area Code Phone Number Yahrtzeit Information Input information about the deceased in this section. For more information about the Yizkor prayer, click here. Full Name 1 of the deceased First Name Last Name Hebrew Name If known. If not, enter the English name. Father's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Mother's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Your Relationship to the Deceased Date of Passing (if available) Time of Day DayAfter Dark Additional Names Input additional names for Yizkor Full Name 2 of the deceased First Name Last Name Hebrew Name If known. If not, enter the English name. Father's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Mother's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Your Relationship to the Deceased Date of Passing (if available) Time of Day DayAfter Dark Additional Names Input additional names for Yizkor Full Name 3 of the deceased First Name Last Name Hebrew Name If known. If not, enter the English name. Father's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Mother's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Your Relationship to the Deceased Date of Passing (if available) Time of Day DayAfter Dark Additional Names Input additional names for Yizkor Full Name 4 of the deceased First Name Last Name Hebrew Name If known. If not, enter the English name. Father's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Mother's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Your Relationship to the Deceased Date of Passing (if available) Time of Day DayAfter Dark Additional Names Input additional names for Yizkor Full Name 5 of the deceased First Name Last Name Hebrew Name If known. If not, enter the English name. Father's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Mother's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Your Relationship to the Deceased Date of Passing (if available) Time of Day DayAfter Dark Additional Names Input additional names for Yizkor Full Name 6 of the deceased First Name Last Name Hebrew Name If known. If not, enter the English name. Father's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Mother's Hebrew Name (of the deceased) If the Hebrew name is not known, enter the English name. Your Relationship to the Deceased Date of Passing (if available) Time of Day DayAfter Dark Additional Names I would like to add pictrues and/or a bio of my Loved One for the Interactive Virtual Yahrtzeit Boad Yes My Loved One Bio/Information Please upload any pictures (up to 6) that you would like to be shown on the screen for your loved one. Picture 1 Picture 2 Picture 3 Picture 4 Picture 5 Picture 6 Comments I would like to make a contribution in honor of the deceased: Yes Contribution Amount $ Payment 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 Month2025202620272028202920302031203220332034 Expiration YearBilling 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 Total $0.00 100% of the proceeds of this donation or payment benefit Chabad of Coronado. 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