Request an iKwit Kit

Use this form to have an iKwit Kit mailed to you.

You can also request to have an iKwit Kit mailed to a friend, family member or co-worker you would like to encourage to quit smoking.

Include a personal message for the recipient or special instructions for us.

Remember, you have to plant the seed and water it. Plant the seed of becoming an Ex-smoker by requesting an iKwit Kit.

Show your friend, family member or co-worker that you care enough about him/her to take the time and effort to request an iKwit Kit.

1. Name
2. Address
3. City
4. State
5. Zip
6. Phone
7. Your email
8. T-Shirt Size
   
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   T-Shirt Style
   
   Male Female  
   
Message