Resistance Party-in-a-Box Registration
Please fill out the form below to nominate a group to receive a box or to request a box for your own group.
Name *
Your answer
Contact Phone Number *
Your answer
Contact Email *
Your answer
Address to receive box *
Your answer
Group Type
Describe your group
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Approximate number of attendees *
When do you want to receive a box? *
Your answer
Nominated by *
Your answer
Other comments
Your answer
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