Cell Phone Order Form

To ensure availability for the first day of Yeshiva, please return this form by August 10.

Orders requesting home delivery must be submitted by August 5.

Parent Name

Student Name

Parent Email

Parent Phone

$25 per month

+ $80 one-time equipment package ($50 phone + $30 filter)

Order Selection

I would like to purchase an MTI-approved phone with a new Yeshiva plan.

Phone Delivery

Pick up the phone from the Yeshiva.

Ship the phone to my home. (Add $10 shipping fee. Order must be received by August 5.)

If you chose home delivery, please enter your address

Number Porting (Optional)

I would like to port a current number to the Yeshiva plan. Please allow one week.

Current Carrier

Current Phone Number

Current Account Number

Current Account PIN

Current IMEI Number

Additional Notes