Remember Us - Name Request Form

Name Request Form

To request the name of a lost child to remember please fill out the Name Request Form below. If the date of the bar/bat mitzvah is less than 14 days away we will send you your name via email.

There is no charge to participate. Voluntary donations sustain and continue Remember Us. Please make a donation so that we can bring this opportunity to another child. Please click here to donate.

Please feel free to contact us for more information.

remember@sonic.net
Gesher Calmenson, Director
(707) 570-2883
2777 Yulupa Avenue, #273
Santa Rosa, CA 95405

*What is the date of the bar/bat mitzvah?

*How did you hear about us?

*What is the name, address, and affiliation of your synagogue?

*Who is the Rabbi or Cantor the bar/bat mitzvah student is studying with?

*What is the bar/bat mitzvah’s full name?

What is your contact information?
*Name:
*Mailing Address:
*Phone:
*Email:
Questions/Comments:
*required fields