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National Wear Red Day Events

Tell Us What YOU Are Doing!

Americans across the country will raise awareness about women and heart disease through National Wear Red Day events and awareness activities at clinics, hospitals, workplaces, and other public places.  To celebrate this important day and the commitment of thousands of people, The Heart Truth is developing a list of local activities taking place nationwide to share with national and local media outlets.  And we want to include YOUR special event.

Please print and complete this form and fax it to The Heart Truth media team at 202-729-4001, Attn: Heart Truth Media by January 11, 2008.

Completion of this form is voluntary.  Completing this form indicates your willingness to post your activity for public use as a part of The Heart Truth campaign promotional materials for February 2008.  Before we can post your activity, you must identify yourself so that we can easily verify or clarify any information if necessary.   NHLBI will use your personal information only in the ways indicated in our Privacy Statement.  Only activities that feature women's heart health will be accepted.  Submissions that promote businesses or commercial activities or products will not be accepted.

Organization Name:

Title of Your National Wear Red Day Activity or Event:

Date(s) of Your National Wear Red Day Activity or Event:

Description of Your National Wear Red Day Activity or Event:  (make sure to include activity/event details, location and the estimated number of people who will be attending)

Partner Organizations:  (include other organizations, if any, that will support your Wear Red Day event and how they will be involved)

More information about your organization:  (include details about your group such as who you serve, where you are located, and how many members you represent)

Contact Information:  (Name, title, phone/fax, address, email, etc.)

Organization Web Site:

Print Name:

Signature:

Date:

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