Please print out and send in this form OR click here to download the form and email to the temple office.
The following information must be provided before picking up plaques from Temple Beth Am.
Your Name: ____________________________
Mailing Address: ___________________________________________________________
Phone Number: ____________________________________
Name(s) on requested plaques (and location if you know it):
Temple Beth Am will attempt to honor all requests for plaques.
The person requesting the plaque must be the person who picks up it up. In the event that is not possible, a letter of authorization with the name of the person picking it up must be submitted to the office in advance of pick up date.
All persons picking up plaques will be issued a written receipt.
If you want the plaque(s) mailed, you must pay all shipping charges in advance.
Cost for mailing is:
1 plaque $3.64 2 plaques $4.21 3 plaques $4.78
Times for plaque pick up will be between 1:00-4:00PM on the following Sundays:
February 5th & 12th for plaques located downstairs in Chapel & Halls
March 5th & 19th for plaques located in main Sanctuary, as well as Simcha Wall and other plaques, where possible. (Simcha bricks outside main entrance may not be able to be removed intact.)
Temple Beth Am and its representatives assume no liability for damaged or scratched plaques.