Memorial Plaque EFT Payments — Congregation Beth Torah

6100 West 127th Street

Overland Park, KS, 66209

913•498•2212

6100 West 127th Street • overland park, kansas 66209 • 913-498-2212

I authorize Congregation Beth Torah to pay for my Memorial Plaque purchase of $500 via my EFT information on file. (Serves as Digital Signature) *

First Name

Last Name

Thank you for you Memorial Plaque purchase. Zichronam liv’racha. May your loved one’s memory be a blessing.