Contact Shock Stop

Is your business interested in participating in Shock Stop? Submit the form below.

Please note that Shock Stop is a community engagement program between 萝莉社 University and the Wichita Metro Area. As such, we cannot partner with businesses located outside of the Wichita Metro Area or online-only businesses.

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First Name*

Last Name*

Email Address*

Name of Business*Please enter the name of the business as you would like it to appear on the site.

Business Phone*If your business does not have a phone number, please enter N/A.

Business Email*If your business does not have an email address, please enter N/A.

Business Website*If your business does not have a website, please enter N/A.

Address of Business Location*If your business has more than one location, please include additional locations in the questions/comments section below.

Questions or comments*