• MD Pays Back To School

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Your Information

Your Name (required)

Your Age (required)

Gender (required)

Ethnicity (required)

Your Email (required)

Your Phone (required)

What school do you attend?

What are Your interest?

Instagram User Name



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General Information

What Is Your Favorite Fast Food?

What Toothpaste Do You Use?

What is Your Favorite Hair Care Product?

Do you eat breakfast before school begins?

Do you like POP, Rock, Hip Hop, RandB, Gospel or Afro Beats?

Do You have an Iphone or Android?

What Is Your Favorite App?

AUTO (Optional -16 Years Or Older)

Are You Ready For Driving Lessons?

Do you use bluetooth in the car?
Y or N: Do you stream MEDIA from QR Codes? Y or N

Do you own a Debit Card?

Do You Have a Savings Account?

Are you interested in building a Savings Account for Black History Year 2023?