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Inscribe a Name

Now you can preserve the memory of lost friends or loved ones for all time…
Inscribe their names in the Holocaust Memorial Park.

Apply online or download form in Adobe PDF or Word format.

Registration Form
Yes, I want to take this opportunity to preserve the names of the victims of the Holocaust for all time!
Please inscribe the following name(s) in the Holocaust Memorial Park:

Inscription Information

Name for Inscription

Language to be Engraved

 English Hebrew Yiddish Russian

Relationship to you

Birthplace

Please, write briefly what you know about the victim's experience in the Holocaust
(e.g. camp or ghetto experience).
You can submit any documents and photos to include in our archive

My Contact Information

First Name

Last Name

*E-mail Address

Street Address

City            State           Zip

Phone (Day)

Phone (Evening)

Donation to the Holocaust Memorial Committee

Please enclose a deposit for 50% of the total amount for the inscription. Make your tax deductible check payable to the Holocaust Memorial Committee and mail it together with the registration form to:

Holocaust Memorial Committee
60 West End Avenue, Brooklyn, NY 11235

After receipt of your registration form and check, we will send you a typed confirmation of the inscription for your approval. Full payment will be due prior to the engraving in the Holocaust Memorial Park.

Donation for Inscription

 $360 per line (approximately 26 characters including spaces)
Total: $

The Holocaust Memorial Committee is a not-for-profit organization under section 501(c)3
of the Internal Revenue Code and your donation, for which you received
no material goods or services, is fully tax deductible.

   

For any additional information please contact Holocaust Memorial Committee.
Phone: (718) 743-3636   •   Fax: (718) 648-8143   •   Email: HMCorg@aol.com
Holocaust Memorial Committee - Brooklyn, New York