Name *

First Name

Last Name

Your Phone Number *

(###)

###

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Event Date *

MM

DD

YYYY

Event Time *

Hour

Minute

Second

AM PM

Event Location *

Please note that there is an additional fee if you are further than 30 miles from Kent, Ohio

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What type (and price) of pops are you most interested in? *

Select as many as apply.

Stocked Pops ($30+/dozen)

Custom Pops ($40+/dozen)