Trauma & Therapy Submission

1

What is your full name?This can be your legal name or chosen name

First Name

Middle Name

Last Name

2

EmailIf selected, a member of our team will come in contact with you directly. We will not use any email submitted here for anything other than the purpose of contacting you about your submission

example@example.com

3

Please verify that you are human* This field is required.

4

What is the theme of this pieceIf selected we will place your piece into its related drop accordingly

For Example; Sexual Assault, Military Trauma, Domestic Violence

5

Is the background black?Our first hoodies will be black in color, this may change later

YESNO

6

Are words Trauma & Therapy within the piece?These words have to be visible and written at least once within the piece

YESNO

7

Where is Trauma & Therapy located within the piece?

8

Does the piece contain three colors max?In the future we hope to expand on this and will notify through our social media when more colors become available

YESNO

9

What are your hex codesThere can be up to three

10

I understand by signing this submission form that submitting my work is not guarantee of selection

YESNO

11

File UploadPlease upload design here, if selected we will contact you about optimizing your design size

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

12

Signature

Powered by Jotform SignClear