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Congenital Heart Defect Awareness Week
February 7-14, 2010 

An international coalition of families, individuals, non-profit organizations, support groups, and health professionals participate in a campaign to increase public awareness of Congenital Heart Defects and Childhood Heart Disease.

CHD Week Volunteer Proclamations Participants Calendar CHD Lobby Day  

How can you help?

Matt Imperati carrying the Olympic Torch for CHD Awareness (February, 2002)
Matt Imperati carrying
the Olympic Torch for
CHD Awareness (Feb, 2002)
 

Click on the links below to download information sheets with lots of ideas to help you get started!

If you or your organization are already at work planning CHD Awareness Week activities, please submit this form to let us know about your plans!. We will include your event in our online calendar, and will add the name/names of the organizations you represent in the CHD Awareness Week section of our site. 

Note: if you are a Healthcare Professional, please click here to use the professional signup form.

 CHD Week Registration Form

Please enter your contact information
Except as described under "Permission", this information will not be shared
.
Be sure to read our privacy statement.

First Name
Last Name
Organization
(Optional)
Mailing Address
City
State/Province 
Zip or Postal Code 
Country
Daytime Phone
Evening Phone  (Optional)
Email Address
(enter "none" if none)

Are you a
C.H.I.N. Member?
Yes
No* 
 
* Please note that membership is not
required to participate in CHD Week events

Are you already working on CHD Week 2010?
(If not, please skip to the next "Volunteer" section)

Please check
all that apply
I am currently a State Coordinator
Event Coordinator
    with Hospital Participation
 
I am working on
State Proclamation Signing
Local Proclamation Signing
Fund Raising
Raising Awareness in the Community
 
Other:
Has a Date and Location been set for your event or
Proclamation Signing?
No
Yes! (Please indicate where and when)


 
What hospitals, support groups, and/or organizations are participating?
 
Do you have corporate or private sponsors for your events? No
Yes!
(Please list below)

Please check here if we can recognize
your sponsors on our site and in our
newsletters

Would you like to Volunteer for CHD Week 2010?
(please skip to "Permission" if you are already working on CHD Week events)

I would like more information about: becoming a State Coordinator
Event Coordinator
    with Hospital Participation
State Proclamation Signing
Local Proclamation Signing
Fund Raising
Raising Awareness in the Community
Blogging
Using Facebook or MySpace

Other:

Permission

I hereby grant  permission to C.H.I.N.
to publish my name and email address
on the web site .
(We will not release any other information without your permission.)
Please do not share my name or email but contact me privately

Comments and Feedback (Optional)

 
    
 
Please report problems with this form to <sysadmin@tchin.org>

   

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