To personalize your Ketubah, print this form.
Personalization of Ketubah is an additional charge as noted in the item description.
Mail or fax it back to JUDAISM.COM 2028 Murray Ave Pittsburgh PA 15217
FAX: 412-421-6103 Questions? Call 1-800-Judaism or 412-421-3033
Include the following information.
IT IS ADVISABLE TO VERIFY ALL SPELLING OF HEBREW NAMES WITH YOUR RABBI

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Customer Name:_______________________________________________________

Address:______________________________________________________________

City:_____________________________ State:______________ Zip:_____________

Phone #: (H)__________________________ (W)_____________________________

Fax #:________________________ E-mail:_________________________________

Ketubah Artist:________________________________________________________

Ketubah Name:________________________________________________________

Language:____________________________________________________________

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Groom's complete Hebrew name (print name in Hebrew);______________________________________

Groom's complete English name (If Heb/Eng Ketubah); ______________________________________

Groom's Father's Hebrew name (print name in Hebrew); ______________________________________

Groom's Father's English name (If Heb/Eng Ketubah); _______________________________________

(Circle One.)  - Cohen - Levi - Israelite -

Groom's Mother's Hebrew name (print name in Hebrew); ______________________________________

Groom's Mother's English name (If Heb/Eng Ketubah); _______________________________________

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Bride's complete Hebrew name (print name in Hebrew)_______________________________________

Bride's complete English name (If Heb/Eng Ketubah). ________________________________________

Bride's Father's Hebrew name (print name in Hebrew) ._______________________________________

Bride's Father's English name (If Heb/Eng Ketubah). _________________________________________

(Circle One.)  - Cohen - Levi - Israelite -

Bride's Mother's Hebrew name (print name in Hebrew) ._______________________________________

Bride's Mother''s English name (If Heb/Eng Ketubah). ________________________________________

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Is the Bride a convert? YES NO
Is the Groom a convert? YES NO
Is the Bride's Father living? YES NO
Is the Groom's Father living? YES NO
Is this a first marrige for the Bride? YES NO

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City where the ceremony will take place:___________________________________________________

State (or Country if outside U.S.) or where the ceremony will take place:_________________________

Date and time of ceremony; _____________________________________________________________

(Circle One) - Before Sundown -  After Sundown -

Name and daytime telephone number of person to

call in case of questions; ______________________ Phone #(___)____--_____.

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(Personalization will be charged upon receiving the fax.)

Mail or Fax this form;
Fax #: (412) 421-6103.
JUDAISM.COM
2028 Murray Ave.
Pittsburgh PA 15217

Customer Signature:______________________________________________________

Rabbi's Signature (Suggested):_____________________________________________

Rabbi's Phone # (Suggested):_______________________________________________

Please allow 4 to 6 weeks for delivery of your personalized Ketubah.