A Shining Chanukah

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* 1. What's your full name?

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* 2. What's your (or your parent's) email address?

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* 3. What Yeshiva are you in?

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* 4. What grade are you in?

1st through 3rd

4th through 6th

7th and up

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* 5. How are you raising money? Choose all the apply.

Phone Calls

E-mails

In Person

Social Media

Other (please explain)

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* 6. What's the best phone number to contact you?

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* 7. The MJYA Foundation will be giving sponsored prizes out to those that raise specific amounts as shown on the website. If we are unable to obtain the prize requested for any reason, we will give the Amazon Gift Card for that amount. If you are collecting money with siblings, you can only request prizes based on the amount raised, not per person. Do you understand?

Yes

No

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* 8. Have you ever fundraised for the MJYA Foundation before?

Yes

No

I'm not sure