Chanukah YJP Registration Form 2021

Chanukah Party Sign Up

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

First Name Last Name
E-mail: *
Cell Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
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- $25 AFTER 11/30 - $30 Sponsor $180 includes 2 tickets Mitzvah Sponsor $540 includes 4 tickets Event Sponsor $1800

Amount?

USD Enter payment amount

Chanukah Party Sign Up