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Leslie Gallant

Thursday, June 4, 2020
6:00 PM 8:00 PM 18:00 20:00

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Date and Time

6/4/2020 from 6:00 pm- 8:00 pm

Name

First Name

Last Name

Email

Number of Counters

Address

Mailing Address (Please share if you don't yet receive mail from KELT. We would love to send you a thank you letter for counting!)

Address 1

Address 2

City

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Phone

Phone Number (In case we need to get in touch with you about updates for the count)

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