The Kindness Revolution (Short) Form
Name *
Your answer
Best way to contact you (Phone, Email) *
Your answer
Number of Bracelets *
Your answer
What will the Bracelets be used for? *
Your answer
Where Do You Pick Them Up?
You can pick the bracelets up at Bill Quickel's - Insurance Plus Agencies office at 114 COURT STREET POMEROY, OH 45769 Our phone number is 740-992-6677 and our email is Hours of operation are Monday-Friday 9am-5pm

Thank you for your interest!

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