Apply for Free Smart Heated Gloves - Scleroderma Atlantic

Win Smart Heated Gloves

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Scleroderma Atlantic is pleased to announce that a portion of the funds from our holiday 50/50 raffle will go towards purchasing 2 pairs of Smart Heated Gloves from Quanta Vici for members of our community. In order to qualify for the raffle, please fill out the form below.

Best of luck!

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Full Name

Phone Number

Preferred Glove Size

I confirm that I am living with scleroderma.

Mailing Address Line 1

Mailing Address Line 2

Postal Code

Province

Please briefly explain how the gloves will help you.

If I am the chosen winner, I allow Scleroderma Atlantic to share my experience described above on marketing channels.

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