Nominate a Cancer Survivor for a Clutch Hair Transformation
Submit information below to enter someone you know (or yourself) into our Pink October giveaway for a complimentary hair transformation.
Survivor Name
First Name
Last Name
Survivor Phone Number
-
Area Code
Phone Number
Does the survivor live in the Kansas City area? If not, would they be willing to travel to receive the service?
Yes
No
What kind of cancer did the survivor have?
Any additional information you want to provide?
Submit Form
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