“I’ve Got Your Back” Bracelet Campaign Help Aevidum spread 48,824 ripples of hope. Bracelet Campaign Order Form Your InformationName(Required) First Last Email(Required) Enter Email Confirm Email Mobile Phone(Required)Mailing/Billing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Your Bracelet Pack OrderPlease select the desired quantity of bracelets you want from each category/color options below. The items below are sold in packs of two for the price shown, no shipping is charged with your donation to this campaign! The order will be shipped to the billing/shipping address you provided above. Please, only enter USA shipping addresses.White “Got Your Back” Silicone Wristband Quantity Price: $4.00 Quantity Teal “You Belong” Silicone Wristband Quantity Price: $4.00 Quantity Black “Not Alone” Silicone Wristband Quantity Price: $4.00 Quantity Gold “Got Your Back” Friendship Bracelet Quantity Price: $10.00 Quantity Teal “You Belong” Friendship Bracelet Quantity Price: $10.00 Quantity Pink “Not Alone” Friendship Bracelet Quantity Price: $10.00 Quantity Do You Want To Help Aevidum With An Additional Donation? Yes No Optional added donation to Aevidum.This is an optional field to send an additional donation to Aevidum, to help with shipping materials and other related costs. $3 To Cover Card Fees $6 To Cover Material Fees $10 To Cover Future Campaigns Order Total Your Payment InfoCredit Card(Required) Cardholder Name Card Details Human VerificationPlease type the word AEVIDUM for the submit button to appear. Once it appears, click "Submit" to place your order.