Know Your Lemons Global Education Program Application Form

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Thank you for wanting to change the picture of breast cancer by being a part of our global effort to save lives through education and early detection. Whether you are passionate about women's health, have a healthcare background, or both, as a Certified Know Your Lemons Global Educator (or Certified Lemonista, as we like to say!), you will be doing the important work of educating people in your communities using the Know Your Lemons® teaching tools.

Please fill out this application form and we will be in contact with you shortly. In the meantime, if you have any questions, please reach out to volunteer@knowyourlemons.org.

Email address: *

First Name *

Last Name *

Are you part of an organization or an individual?

Part of an Organization

I am an individual

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If you are part of an organization, what is your organization's name? *

Address Line 1 *

Address Line 2

Phone number (please include country code) *

City *

State/Providence/County *

Country *

Postal Code *

How many people do you estimate you will educate in a year about breast cancer? *

How many educators do you estimate you will enroll in the online training course? (Available only in English) *

If you are an individual, just type "1".

How long has your organization existed? *

I am an individual, not part of an organization.

less than 5 years

5-10 years

11-15 years

16-20 years

20+ years

What is your annual operating budget? *

What services or events do you offer? (check all that apply) *

free or discounted mammograms/screening services

education sessions (like a "lunch and learn" corporate seminar, or community meeting)

breast cancer walk/run fundraiser

patient support phone number or chat service

health fairs

Other:

Required

If you are an organzation, what is your annual *marketing budget* (in USD) for your programs/services for breast cancer? *

(Answer in US dollar amounts, answer "0" if you are an individual)

Do you currently teach about more than breast cancer? *

(Such as other cancers, or other health areas?)

Yes

Other:

How many followers do you have on Facebook, Instagram and Twitter combined? *

(If you are an individual, add up your personal network.)

What is your facebook page address?

What is your instagram handle?

What is your twitter handle?

Do you teach in settings where technology isn’t available, such as a not having a projector or TV to teach with? *

Often, usually no technology

Rarely, technology is usually available

Sometimes

Are you interested in information on using Know Your Lemons as a health promotion campaign for the general public? *

Using Know Your Lemons to promote your organization is available only to Know Your Lemons Campaign Partners. We can send you information about our campaign services and benefits.

Yes

Do you agree to report statistics on the impact you are making as an educator? This includes information such as number of people educated, location of teaching sessions and other general information. This is a key requirement of membership, and your membership will be revoked if you do not report your activities. You must accept this to be considered. *

Yes

Briefly describe why you want to be a volunteer with Know Your Lemons and become a Global Educator for breast health in your community. *

Has breast cancer affected you or someone you love? *

Why is our organization important to you? *

You stated that you would be able to educate an estimated number of people each year. What are your plans for reaching that goal? Do you have any events planned? Digital/Virtual events count as well. *

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