Giving Life a Second Chance
Through Organ & Tissue Donation

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Join Team Philadelphia:

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Register to be a part of Team Philadelphia as we compete for the gold!

 

Volunteer Application


* Required Fields
Date
First name*
Last name*
Birth date*
Main phone*
Cell*
Work
Email address*
Retype Email address*
Is email a reliable way to reach you?*
YesNo
Address*
City*
State*
Zip Code*
County*
What languages do you speak?
Ethnicity (Optional)
I am most interested in working with...*
General Public (Community Health Fairs, festivals, sports and cultural events)
Multicultural Communities (Hispanic, African American and/or Asian outreach)
Hospitals (Staff Presentations, hospital health fairs)
Schools (Presentations to high schools, colleges and trade schools)
Civic Organizations (Rotary clubs, Women’s Clubs, special interest organizations)
Faith-based Organizations (Presentations to congregations and religious groups)
Media (Press conferences and on-camera and radio interviews)
Help us clearly understand your relationship to donation by completing all sections:
I am a transplant recipientI am a donor family member
I am a living donorI am someone on the waiting list
Other
Please explain...
If you are a transplant recipient, what is the date of your transplant?
What type of transplant did you receive?
Name of Transplant Center
I would like to utilize the following skills
SpeakingTabling (Health Fairs)
MediaWriting
Photography/VideographyWeb/Graphic Design
Event Planning/CoordinatingOther
Describe how you have used these skills in past experiences
Availability: Please check what days and times you are usually available to volunteer for at least one hour.
Weekday morningsWeekday afternoon
Weekday eveningsWeekend mornings
Weekend afternoonWeekend evenings
How did you hear about Gift of Life Donor Program?
Family member or friendGift of Life Speaker
Civic GroupGift of Life website
Transplant Center or HospitalGift of Life mailing
I would like more information regarding the following volunteer groups listed in the brochure:
Liaisons for Life (Philadelphia)Hearts of Gold (Donor Families in Philadelphia)
Multicultural Affairs (Philadelphia)Southern New Jersey Coalition
Central Susquehanna CoalitionCapitol Coalition
Berks County CoalitionCentral PA
Northeast PA CoalitionLehigh Valley Coalition
Delaware Coalition North (Newark)Delaware Coalition South (Dover)
Southcentral PA


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Gift of Life Family House

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Lodging and Support

Thousands of patients come to Philadelphia hospitals every year needing life-saving organ transplants. Family House will provide critically needed support programs and temporary lodging for organ transplant patients and their families.

 

iconGive to Gift of Life

A contribution today will help us fulfill our mission to increase awareness of organ and tissue donation to help save lives.

 

Register for the 2014 Dash

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The Dash for Organ and Tissue Donor Awareness is designed to help promote organ and tissue donation and highlight the success of transplantation. April 13, 2014.

Learn more about the event and register today!

 
 
 
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