Would you like to be a lung cancer spokesperson?

Have you been touched by lung cancer? Would you like to tell your story? Would you allow us to share your contact information with a journalist who may be interested in speaking with you?

Whether you are a lung cancer survivor, loved one of someone with lung cancer or healthcare provider, everyone has a story. We want to help you tell yours.

Please fill out the form below. We will notify you as any opportunities may arise. Sometimes journalists are looking for a local story. National media outlets have more geographic flexibility.

NOTE: Please understand that journalists often work on very tight deadlines, so immediate responsiveness may be imperative.


All fields are required to complete this form, unless otherwise noted.
First Name: 
Last Name: 
Street Address:  
City:  
State: 
Zip: (5-digit Zip)  
E-mail address:  
Alternate E-mail address:  (optional)  
Home Phone:  (ex: 000.000.0000)   
Work Phone:  (ex: 000.000.0000)  (optional)  
Mobile Phone:  (ex: 000.000.0000)  (optional)  
Time Zone:
 
Please provide a brief explanation of how lung cancer has impacted your life:
  

Thank you for your willingness to speak out about lung cancer!

Note: A confirmation message will be sent to your e-mail address when you click "Submit".

 
Copyright © 2010 Dusty Joy - All Rights Reserved.
The information on this website is not intended as a substitute for medical care. Please speak with your healthcare provider if you have medical questions or concerns about any information on this site.