Get in line...

John, exactly what information does it ask for? (Still need this information despite what's written below)

Offer's off the table. Got a recipient

Lets see if i remember it all;

First name, last name, email address (i think) address, (address line 2 available), state (drop down box), city, and zip code.

You dont have to rush on it, so messaging the person is possible, but not 100% i would say.