PR List Application

PR List Application
Customer Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail
example@example.com
Birthday (for legal age)

MonthDayYear
Date
How did you hear about us?*
Please Specify*
Please list any social media you currently use most often: (INCLUDE YOUR HANDLE/USERNAME)
Are you wanting certain products or PR for a special event? If so, please describe your event and/or requested products + a date you need them by (if available):
Sizes (S-5XL)
Please list sizes for short sleeve and long sleeve t-shirts, hoodies, crewnecks, and sweatpants!
Should be Empty: