Tick Defender Fundraising Donation Request
Please fill out this form to receive a Tick Defender Gift Certificate to use for your organization's fundraiser.
The certificate is good for a Free Tick Yard Protection Application. Up to a $100 Value.
Email address *
Event Date *
MM
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DD
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YYYY
Organization Name *
Your answer
Organization Website *
Your answer
Event Type *
Annual Event *
Contact Name *
Your answer
Event Mailing Street Address *
Your answer
Event Mailing City, State, Zip *
Your answer
Phone Number *
Your answer
Contact Person *
Contact Email *
Your answer
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