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Registration Form/Forma de Registración
2024 ALAS-Wings: April Programs / Programas de Abril
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Email
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Your email
First Name / Primer Nombre
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Your answer
Last Name / Apellido
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Your answer
Mobile Number / Número de Celular
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Your answer
Address / Domicilio
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City/State - Ciudad/Estado (ejemplo; Chicago, Illinois)
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Zip Code / Código Postal
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Category / Categoría
Person with Cancer / Persona con Cáncer
Family Member of Someone with Cancer / Familiar de Persona con Cáncer
Community Organization / Organización Comunitaria
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Organization Name / Nombre de Organización (If you are not a survivor or family member, what organization are you representing? / si no es sobreviviente o familiar, ¿Qué organización representa?)
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4 de Abril: “El Cáncer de la Piel”
17 de Abril: “Conversando con Viviana: Charla Abierta “
10 de Abril: “Grupo abierto con el equipo de ALAS-Wings"
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