LungXperience Volunteer Sign-up Form
LUNGevity is proud to participate for the second year in the LungXperience Tour, a national mobile health initiative in partnership with AstraZeneca and Kroger Health. LungXperience is an interactive, outdoor experience designed to raise awareness about lung cancer and empower people to take action for their health.
First name
Last name
Mobile phone
Email
Street Address
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Montana
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Nevada
New Hampshire
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Ohio
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South Carolina
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Texas
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Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
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Zipcode
Are you part of any of these groups or organizations? (check all that apply)
American Lung Cancer Screening Initiative
LUNGevity Early Lung Cancer Detection Network (ELCDN)
LUNGevity Action Network
LUNGevity Community Ambassadors
Team LUNGevity
LUNGevity Staff
Are you a healthcare provider?
Yes
No
What hospital/healthcare organization are you with?
Which event(s) do you plan to volunteer at? (check all that apply)
Feb 20-22 - EchoPark Speedway (Atlanta) - Hampton, GA
March 6-8 - Phoenix Raceway - Avondale, AZ
March 20-21 - NHRA Phoenix - Chandler, AZ
April 17-19 - Kansas Speedway - Kansas City, KS
April 24-26 - NHRA Charlotte - Concord, NC
May 1-3 - Texas Motor Speedway - Fort Worth, TX
May 14-17 - NHRA Chicago - Joliet, IL
May 29-31 - Nashville Superspeedway - Lebanon, TN
June 5-7 - Michigan International Speedway - Brooklyn, MI
June 12-14 - Pocono Raceway - Long Pond, PA
June 19-21 - San Diego (Naval Base Coronado) - Coronado, CA
July 3-5 - Chicagoland Speedway - Joliet, IL
July 24-26 - Indianapolis Motor Speedway - Indianapolis, IN
Aug 1-4 - Ohio State Fair - Columbus, OH
Sept 2-7 - NHRA Indianapolis - Indianapolis, IN
Sept 25-26 - Kroger Health & Wellness Festival - Cincinnati, OH
Oct 2-4 - Las Vegas Motor Speedway - Las Vegas, NV
Oct 16-18 - Phoenix Raceway - Avondale, AZ
Oct 23-25 - Talladega Superspeedway - Talladega, AL
Oct 29-Nov 1 - NHRA Vegas - Las Vegas, NV
Nov 12-15 - NHRA Pomona - Ponoma, CA
When are you available to volunteer? Please list the date(s) and time(s):
How did you learn about LungXperience?
LUNGevity email
Social media
Word of mouth
Other
Do you already have enough LUNGevity shirts you can wear throughout the event(s)?
Yes
No
Shirt Type
V-Neck
Crew Neck
Shirt Size
Please select...
X-Small
Small
Medium
Large
X-Large
XX-Large
XXX-Large
XXXX-Large
Lead Source
Organization
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