Helping patients with blood cancers
live better, longer lives through apache
Please complete all required fields:
Contact Information
Title
First Name *
Last Name *
Suffix
Phone
Select Phone Type:
Fax
Address *
City *
State *
Zip/Postal Code *
Email *
Select Email Type: *
Volunteer Interests
I am interested in the following activities. Please check all that apply.
Advocacy Program
Office Help
Fundraising Events
Solicit Sponsors
Chapter Committee Service
Chapter Board of Trustees
Patient Support
Speakers Bureau
Donor Development
Public Relations
Other (please specify below)
Best Days and Times for Volunteering:
Please check all available days and times.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Mornings
Afternoons
Evenings
Have you participated in a fundraising event to benefit LLS?
Yes
No
If yes, which event?
Comments...Tell us what you are interested in doing
Additional Information (Optional)
Have you or somone you know been touched by leukemia, lymphoma, Hodgkin's disease or myeloma? Or any other type of cancer?
Yes No
If yes, please describe:
Do you speak a language other than English? Yes No
If yes, please describe:
Employer Information
Occupation
Employer
Title
Address
City
State/Province
Zip/Postal Code
Phone
Is there anything else you would like us to know about you?
Please click the Submit button below to send this information to your local Chapter of The Leukemia & Lymphoma Society. Thank you.
  

The Leukemia & Lymphoma Society (LLS) is the world's largest voluntary health agency dedicated to blood cancer. The LLS mission: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. LLS funds lifesaving blood cancer research around the world and provides free information and support services.