In the form of gift cards, how much funds are you requesting?
Clear selection
Contact information: Please provide us with your name and a mailing address below, for your gift card(s). Assistance is dependent on available funds. We will contact you if and when we can to assist you. We kindly request a photo of your purchase (only) so that we can share it with our sponsors, and on social media.
Your answer
Disclaimer: All assistance will come in the form of gift cards, with a maximum of $200/year, per person. Special circumstances may be considered in some cases. Trailblazers Inc reserves the right to deny any request, at any time.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Trailblazers Inc.. Report Abuse