Military & First Responders

NAME:

Address:

Phone:

Email:

Branch of Service:

ID Verification Attachment:

Who referred you:

Comments:

*dwell CBD reserves the right to verify official credentials for all applications submitted in response to this program offer and may abnegate to provide access or discounts pursuant to all applicable protocols as designated by the company.  All submissions will be processed confidentially and never shared outside the company, subject to KRS 61.878 (5).  By this submission, applicant verifies the authenticity and validity of all required details and credentials and hereby agrees to keep applicable discounts and promotions in confidence, which may be reversed or rescinded at any time if the company determines or establishes any abuse or misconduct.