Chanukah YJP Registration Form 2021

Chanukah Party Sign Up

Ticket includes: Dinner and TWO drinks. Please consider a SPONSORSHIP!
Full Name*

First NameLast Name
E-mail:*
Cell Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Comments (allergies, questions, concerns...)
How did you hear about us? friend, Facebook, newspaper, web, direct email or other please specify!*
HOW????
Number attending*
Payment

Prepaid before 11/30- $25AFTER 11/30 - $30Sponsor $180 includes 2 ticketsMitzvah Sponsor $540 includes 4 ticketsEvent Sponsor $1800

Amount?

USDEnter payment amount

Chanukah Party Sign Up