SHARE YOUR STORY

The Leukemia & Lymphoma Society's Washington/Alaska Chapter is proud to offer a vast array of patient services programs as well as an exciting calendar of events. Whether you are attending a support group, forming a team to slog through mud, helping students to raise funds and awareness about blood cancers, donning formal attire for a gala, training for an endurance event, or sailing towards cures, THANK YOU for supporting the LLS mission!

Here at LLS, we are always interested to learn more about why you've joined us! Is it your connection to the mission? A pure physical challenge? Or simply a way to stay active, while applying your efforts to a greater cause?

Share your story with us! We’d love to hear more. With your permission, we may also add your words (or photos and videos) to our ongoing web, Facebook, Twitter, or YouTube conversation about the LLS mission.

Thanks in advance!

First Name *

Last Name *

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Email Address *

Please choose the event/program that you are participating in:

What (or who) inspires you to participate in LLS programs or events?

If you happen to blog or CaringBridge page that relates to the LLS mission or services, what is the URL?

May we include your blog, CaringBridge page, (or the URL listed above) in our chapter's blog roll?

Yes

No

I give LLS permission for the free use to share my story in any broadcast, telecast, print account or any other medium. (Please note, full names will never be disclosed and you will be contacted in advance before your story is shared with members of the broadcast or print media.) *

Yes

No

Do you want to request a dedication sign? Fill out our dedication request form, and we will create a sign for use at your event. (Posters for indoor events, weather-resistant signs for outdoor events.)

Patient Education or Support Program	Big Climb Seattle
Leukemia Cup Regatta	Light The Night Seattle
Light The Night South Sound	Man & Woman of the Year
Pennies for Patients	Pineapple Classic 5K
Scott Firefighter Stairclimb	Team In Training
Other Other