#TidalWaveofAT Kit - Request Form

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If you’re interested in our #TidalWaveofAT Kit, please complete this Google Form.
Within 24-48 hours of form submission, a team member will contact you to obtain additional information or to confirm your request. If you'd like to send a follow up email, you can contact Leigh Anne Brewster at labrewster@pky.ufl.edu

Your Name *

Are you affiliated with an FRC Team? If so, what's the name and #? (If not, please put N/A) *

What is your affiliation with FIRST? *

Student

Mentor

Parent

Coach

Volunteer

FIRST Employee

Other:

Your Address *

Best Contact Phone # *

Delivery Address for the #TidalWaveofAT Kit (if not receiving in person - put N/A if in person) *

Your Email Address *

If associated with a team, please provide at least one of your Social Media Platforms and Handle. *

How Did You Hear About Our #TidalWaveofAT Kits? *

Would you like us to follow up with you via email for more additional information about the #FIRSTwithAT Initiative started by our team? *

YES

Other:

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