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Through Organ & Tissue Donation

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Volunteer Feedback Form

Thank you for taking the time to submit your volunteer activity information. Please enter your information and click the "Submit Feedback" button. Please note that the asterisks (*) indicate required fields. Your information cannot be accepted without all required fields.


* Required Fields
Volunteer Name (First, Last)*
Volunteer Email*


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Name of Event (Ex. Bensalem HS Driver's Ed Class, Enon Tabernacle Church, Camden Co. Health Fair, etc.)*
Event Type*
Community ProgramSchool Program
Hospital ProgramFaith-Based Program
Other
Your Role*
SpeakerRegistering Donors (Table)
Other
Event Date*
Number of Hours*
Event Address
Was this event set up by Gift of Life?*
YesNo
If no... Event Contact: (name, email, phone)
Total number of attendees at event*


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Number of Connections (Meaningful Conversations) *If ZERO, please enter "00"*
Did you have the capability to register attendees at this event?*
YesNo
If yes.... How?
Smart PhoneTablet
Laptop ComputerOther
If no..... Why not?
How many people were you able to register at this event? *If ZERO, please enter "00"*
Do you recommend doing this event again? Why/Why not?*
Any additional comments?

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Gift of Life Family House

Image of Gift of Life Family House is located at 4th and Callowhill Streets in Philadelphia, one block from Gift of Life Donor Program.
Lodging & Support for Transplant Families

Thousands of patients come to Philadelphia hospitals every year needing life-saving organ transplants. Many come from out of state or travel great distances. Family House is a refuge for patients and their families who are on this journey.

 

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