Educator Demo Kit Requests

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Health care providers & educators: please complete this form to see if you are eligible for a free GladRags Educator's Demo Kit! If approved, we will mail you the kit, and you will get an email when it ships.
Limit one per customer. International customers will need to cover the shipping cost of the kit. By providing your email address, you agree to allow GladRags to periodically (pun intended!) contact you.

Email *

First Name *

Last Name *

Name of your organization *

Description of organization *

Your role at organization *

Organization's website *

Organization's full mailing address *

Mailing address for the kit, if different than the address above

Submit

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