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ב"ה

Teens Pizza Party Donation

My Jewish Birthday

My Name*
First Name Last Name
My Cell Phone Number*
My E-mail Address*
My Birth Date*

Month Day Year
Name of my Mom or Dad*
First Name Last Name
Email Address of my Mom or Dad (whomever you entered in the previous field)*
Cell Phone Number of my Mom or Dad (whomever you entered in previous field)*
Celebrate your Jewish birthdays with Uptown Chabad at the Pizza Party! 🎉🍕
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