Yahrtzeit - Chabad of Glendale and the Foothill Communities

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Information about the Deceased
First Name
Gender	Male (ben) Female (bat)
Father's Jewish Name (if known)
Relationship (father, mother, wife etc.)
Date of Passing MM/DD/YYYY
After Nightfall?

Information about the Deceased - optional additional person
First Name
Gender	Male (ben) Female (bat)
Father's Jewish Name (if known)
Relationship (father, mother, wife etc.)
Date of Passing MM/DD/YYYY
After Nightfall?

Information about Yourself
Name
Address
City	State: Zip:
Phone
Email
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Chabad of Glendale and the Foothill Communities • 249 North Brand Boulavard Box #594 • Glendale, CA 91203 • 818-240-2750