Partnership Interest Form

Thank you for your interest in becoming a Livestrong Partner!

Organization Name

Organization Contact Name

First Last

Organization Contact Email

Website

Mission Statement

What are the 3 primary services your organization provides?

Year Organization was Established

If nonprofit, please share the most recent 990 available.

Max. file size: 100 MB.

Please share your most recent annual report.

Max. file size: 100 MB.

Please describe your vision for the future of cancer survivorship.

How would a partnership with Livestrong benefit your mission and those impacted by cancer?

How can you help Livestrong deliver our mission to improve the lives of anyone affected by cancer?