Gift of Hope provides donor registration drives, education programs and
speakers at no charge.

Please note we can provide programs only for groups or
audiences of 100 people or more
.

To help us best meet your needs, please provide three options for
dates and times for your registration drive, program or speaker.

Your Information
  *Required Fields
*First Name
*Last Name
*City
*County
*Phone
Best time to call
*E-mail
Where the program will be held
 
*Name of company/organization
*Contact Name
*Phone
*Address

*Location of program (Suite #, cafeteria, etc.) 

*City
*State
*Zip
Program Information
 
Requested dates and times
*First choice of date: 
Time(s):
*Second choice of date: 
Time(s):
*Third choice of date: 
Time(s):
   
Type of Program
Health Fair/donor
registration table
Speaker
Other
Audience (community, church congregation, nurses):
 
# of attendees expected:
Program topic/focus
(donor registry, general donation info, referral process, etc.):
 
Speaker requested Yes No
If yes, length of presentation:
 
Speaker experience preferred
(donation professional, donor family, heart recipient, etc.):
 
   
Additional questions or information for us