Jewish Community of Ojai Yahrzeit Database Form

Please fill out this form to enter your information into the Jewish Community of Ojai Yahrzeit database

* means field is required	Click here for a printable version of this form

Information about the person to be notified

Your First Name

Please enter your first name

This is a required question

Your Last Name

Please enter your last name

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Your gender

Please select YOUR gender

Male

Female

This is a required question

E-mail address

Please enter your e-mail address

This is a required question

E-mail address

Please enter your e-mail address again for verification

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Information about the deceased

Deceased's Name in English

Please enter deceased's English name

This is a required question

Gender of the deceased

Please select the gender of the deceased

Male

Female

This is a required question

Yahrzeit Date

Please select the English month, date, and year of the passing below and click the Get Date button

MonthDateYear

Deceased's Relationship to YOU

Please select the deceased's relationship to you, such as Father, Mother, etc

This is a required question