Mivtzah Purim

Purim Mivtzoim Du'ch

Fill out your report to enter the raffle and earn your free slice of pizza or soft ice cream from Pies N' Fries!

Your Name *

Phone / Email *

Child #1

First Name *

Ben / Bas *

בן (Ben) בת (Bas)

Mother's Name *

School You can pick from the list or type any school

Grade

How many locations did you visit? *

How many people did you read Megillah for? *

Notes / Comments