Obituary Form (Page 2 of 2) in pdf

Obituary Form Page 2

Funeral Arrangements

Place of Burial _____________________________________ Date _______________ Time ___________

Rabbi ________________________________________________________________________________

Funeral Home _________________________________________________________________________

Address ______________________________________________________________________________

City __________________________________________

State ____________ ZIP _________________

Contact for More Information

Name ___________________________________________ Relationship to Deceased _______________

Phone _________________________________ E-mail ________________________________________

Memorial Contributions

Send To ______________________________________________________________________________

Address ______________________________________________________________________________

City __________________________________________

State ____________ ZIP _________________

Additional Information

_____________________________________________________________________________________

Please submit this form by mail to Rob Golub, Editor, The Wisconsin Jewish Chronicle,

1360 N. Prospect Ave., Milwaukee, WI 53202 or by email to .

Questions? Call Rob at 414-390-5770.

Obituary Form Page 2