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Curieus in Quarantine Materials Box Request Form
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* Indicates required question
Parent/Guardian Full Name
*
Nombre de padre/guardián
Your answer
Parent/Guardian Email
*
Correo electónico
Your answer
Phone Number
*
Número de teléfono
Your answer
Address (to safely deliver your box to your doorstep!)
*
Dirección (¡para entregar su caja al umbral!)
Your answer
How many boxes does your family need? (1 per kid)
*
¿Cuántas cajas necesita su familia? (1 cada niño)
Your answer
How did you hear about us?
*
¿Cómo supo de nosotros?
Friend (amigo)
News (noticias)
Flyer (folleto)
Other:
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