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Non-Eastern European Burial Site

Documentation Survey

Please submit the completed form as an attached file [extention .txt] or in the body of an email to Ellen Sadove Renck: This e-mail address is being protected from spambots. You need JavaScript enabled to view it . For snail-mail instructions, contact Ellen Renck.

For each question, check all information of which you are certain. Feel free to include additional or more specific information and also to delete information that is irrelevant to your survey. Responding to this survey grants permission to IAJGS, or its designee, to post any and all of your survey responses on the IAJGS International Jewish Cemetery Project website. Should you wish any information to remain confidential or if you have questions or comments, please contact IAJGS separately. Survey submissions become the property of the IAJGS International Jewish Cemetery Project website on JewishGen.

Please do not include personal comments about family burials in this survey. The project concentrates on full cemetery or cemetery section inclusions.
Thank you.

Use Cut and Paste to move the text below this line to an email window or word document where you can then fill it in

City or town:
Alternate names: (note language)
Latitude __ ____ __'
Longitude __ ____ __'
Current town population:
Town's current Jewish population:
Name of Cemetery:

__ Cemetery destroyed in Holocaust. Skip to JEWISH COMMUNITY INFORMATION section.
__ Cemetery destroyed in post-war Eastern Europe. Skip to JEWISH COMMUNITY INFORMATION

Postal address of cemetery:
Phone number of cemetery:( ) Fax number:( )
E-mail address of cemetery:
URL of cemetery: http://www.
Person to contact about grave locations:
Names and addresses of local funeral home/s and/or monument maker/s:
(Use additional page if necessary)
Check all that apply:
____ Cemetery burials are indexed.
____ Index is computerized.
____ Cemetery is willing to share database/index with the Online World Burial Registry. (If so, please contact the JOWBR.)
Cemetery Hours if applicable:
Flower Policy: __ Flowers Permitted __ Flowers Prohibited __ Other:
Information/burial cards exist only after this date:
Choose one from each set:
____ Some burial cards have biographical data.
____ All burial cards have biographical data.
____ No burial cards have biographical data.

____ Some burial cards have next-of-kin information.
____ All burial cards have next-of-kin information.
____ No burial cards have next-of-kin information.

____ Some burial cards have funeral director information.
____ All burial cards have funeral director information.
____ No burial cards have funeral director information.

____ Some burial cards have health department information.
____ All burial cards have health department information.
____ No burial cards have health department information.

Date of earliest known Jewish community in town:
Date cemetery was established:
Any noteworthy historical events effecting the Jewish community, excluding the Holocaust:
Other towns/villages that use/d this cemetery or name/s, address/es, and telephone of congregations that use/d this cemetery:
Name, address-location, and telephone and/or email of other individual(s) interested in site, who may share information:
The cemetery __is or __is not land-marked. If land-marked, controlling land-mark organization:
Caretaker? __ no __ yes: Caretaker's name, address, and telephone:
Does caretaker have the key? __ yes __ no
Any noteworthy individuals buried in cemetery:
The cemetery is __active __inactive.
If inactive, date of the last known Jewish burial:
Type of Jewish community that uses/used this cemetery: (Check all that apply.)
__Orthodox __Orthodox-Hassidic __Conservative __Reform __Reconstructionist __Sephardic __Neolog The cemetery __ does ___does not contain mass graves.

The cemetery location is __ urban __ suburban __ rural (agricultural) __wood/forest.
The cemetery is located __ on flat land __ on a hillside __ at the crown of a hill __ by water.
The cemetery is __isolated __part of a municipal cemetery __separate, but near other cemeteries.
A sign in __English __Hebrew __other language (specify other language): _____________ marks the cemetery. The sign reads as follows:
The cemetery is reached by __turning directly off a public road __turning off a private road __crossing public property __crossing private property.
Access to the cemetery is __open to all ___entirely closed __open with permission of _____________.
The cemetery is surrounded by __a continuous masonry wall __a broken masonry wall __a continuous fence __a broken fence __no wall or fence __a hedge or row of trees.
The cemetery has __a locking gate __a gate that does not lock __no gate.
Current size of cemetery (specify measurement unit): _______________.
Is the cemetery divided into special sections? __yes* __no __unable to determine. *If the answer is yes, check all that apply: __burial societies __men __women __unmarried men __unmarried women __rabbis __Cohanim __children ___women who died childbirth __suicides __other:

GRAVESTONES/MEMORIAL MARKERS (Please check all that apply.)
Date of oldest known gravestone:
Tombstones in the cemetery date from the following century:
__16th __17th __18th __19th __20th century or exact date:
__-0 __1-20 __20-100 __100-500 __500-1000 __1000-5000
__>5000 gravestones are in cemetery, regardless of condition or position or __ exact number:
__-0 __1-20 __20-100 __100-500 __500-1000 __1000-5000 __>5000 gravestones are in original location or __ exact number:
__-0 __1-20 __20-100 __100-500 __500-1000 __1000-5000 __>5000 gravestones are not in original locations. __ exact number:
__0 __<25% __25%-50% __50%-75% __75% of surviving stones are toppled or broken or __ exact number:
If stones were removed from the cemetery, they are in:
__ another cemetery, Name:
__ a museum or conservation laboratory, Name:
__ private collection/s
__ other location: _________________________________________________

Check all that apply:
THE GRAVESTONES AND MEMORIAL MARKERS ARE __marble __granite __limestone __sandstone __slate __iron __other (specify)__________.
GRAVESTONES AND MEMORIAL MARKERS ARE __rough stones or boulders __flat, shaped stones __finely smoothed and inscribed stones __flat stones with carved relief decoration __double tombstones __sculpted monuments __multi-stone monuments __horizontally set stones __with Sephardic inscriptions __flat, low in-ground plaques __obelisks __mausoleums __other (specify): .
__traces of painting on their surfaces __iron decorations or lettering __bronze decorations or lettering other than metallic elements __portraits/photographs on stones __metal fences around graves __only common gravestones __none of the above.
INSCRIPTIONS ON TOMBSTONES ARE IN __English __Hebrew __Yiddish __other (specify other)___________________.
The cemetery contains special memorial monuments to __Holocaust victims __epidemic victims __Jewish soldiers __none __other (specify):

CURRENT USE OF CEMETERY SITE (Check all appropriate answers.)
The present owner of the cemetery property is __the local Jewish community __the municipality __private individual(s) or corporation __unknown __local synagogue, name:
The cemetery property is now used for __Jewish cemetery purposes only __other: ___________________
Properties adjacent to the cemetery are __recreational __commercial or industrial __agricultural __residential __ other cemeteries __other: _______________.
VISITS TO THE CEMETERY ARE __frequent __occasional __ rare AND MADE BY
__organized Jewish groups/tours __organized individual tours __private visitors __other (specify)_____________________.

MAINTENANCE AND CARE (Check all that apply.)
The cemetery is known to have been vandalized __never __between 50 and 10 years ago __occasionally in the last ten years __frequently in the last ten years.
Past maintenance: __re-erecting stones __patching broken stones __ cleaning stones __clearing vegetation __repairing wall __ repairing gate __no maintenance* __other.
*If answer is "no maintenance", skip to section: "Current Care"
If restoration has been carried out, who was responsible for the work? __cemetery owners __local Jewish congregation NAME:
__individuals or groups of non-Jewish origin __local or municipal authorities __regional or national authorities __Jewish individuals (within the __city __county __state ___region) __other ______________.
Restoration work was carried out on: (Include DATE and NAME of person responsible if known.)

Current Care: __none __no caretaker __occasional clearing or cleaning by individuals __occasional clearing or cleaning by authorities __regular caretaker __paid perpetual care __other: __________________.
If there is a caretaker, how is he/she paid? __not paid __by cemetery __paid by the Jewish Congregation of _________________ __paid by contributions from visitors __paid by the government __other _______________.

STRUCTURES: (Please check all that apply.)
Structures within the limits of the cemetery, include
__no structures. __a chapel. __an ohel [open structure above grave with or without canopy]. __more than one ohel. __sarcophagus [above-ground box]. __ a well. __a mausoleum building. __a mortuary. __a cemetery office. __caretaker's residence. __pre-burial house*. __other structures (specify)__________________.
*If there is a pre-burial house, it has __a tahara (table) __a catafalque __wall inscriptions __a chimney __other distinctive features (specify features):

Please rate problems facing this cemetery, by using the following code:
1. no threat, 2. slight threat, 3. moderate threat, 4. serious threat, 5. very serious threat. If possible, provide specific information on ratings 4 (serious) and 5 (very serious).

__Vandalism (destruction/defacement of stones/graves): 1 2 3 4 5
__Security (uncontrolled access): 1 2 3 4 5
__Weather erosion: 1 2 3 4 5
__Pollution: 1 2 3 4 5
__Incompatible nearby development: __existing ___planned ___proposed) 1 2 3 4 5
The vegetation overgrowth in the cemetery is ___not a problem ___a seasonal problem preventing __a constant problem, disturbing graves __a constant problem, disturbing stones __a constant problem, damaging stones.
Water drainage at the cemetery is __good all year __a seasonal problem __a constant problem, disturbing tombstones or graves.

Person/s completing this survey, if other than cemetery office listed above:

Do you want only your email address shown on the IAJGS International Cemetery Project website:
[ ] yes
[ ] no

Do you want only your snail-mail address shown on the IAJGS International Cemetery Project website:
[ ] yes
[ ] no
__Cemetery office
Date of completion:
The following documentation was used:
__other documentation exists but was not used because it was __too old __too general __inaccessible __not reliable __other reasons (specify)
If respondent visited for this survey, give date of visit: _______
If interviews were conducted for this survey, please give date and name/address/telephone/email of interviewer (if other than respondent) and interviewee:

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