Chanukah Smiles

YES! I want to be part of Chanukah Smiles.
The request form is now closed. Please contact us to see if there are any still available.
Sponsorships can still be submitted
Your Name*

First Name Last Name
Choose one or more options:* Package request must be summitted before 5pm on Tues, Dec 8

Volunteer to deliver a Chanukah care package Nominate an individual or family (or yourself) to receive a package Sponsor a Chanukah care package
Please select one* Pickup Wed, Dec 9 @ Chabad - 1190 Hwy A1A, Satellite Beach, FL 32937

I will pickup for myself I volunteer to pickup and deliver Please find a volunteer to deliver
Name of nominee If nominating someone other then yourself

First Name Last Name

Delivery address If applicable

Your E-mail*
Your Cell Phone

Area Code Phone Number
Sponsor a Chanukah Meal
$25 = Chanukah-in-a-box for 1

$50 = Chanukah-in-a-box for 2

$100 = Chanukah-in-a-box for families with young children (or for 4)
How many meals to sponsor $25 per meal
Donation Amount Optional

$1800 $1000 $500 $360 $180 $100 $54
Total

$0.00

Payment

Credit Card

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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YES! I want to be part of Chanukah Smiles.