School Walk Form : Juvenile Diabetes Research Foundation International

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Thank you for your interest in starting a Kids Walk to Cure Diabetes in your school! Getting started is as easy as 1-2-3!

1. Sign up as a School Coordinator, using the form below.
2. Include a desired month for your Kids Walk.
3. Your local JDRF chapter will be in touch to give you all the tools you need!

Required Field Yes! Our school is interested in helping JDRF find a cure for Type 1 Diabetes! :

Yes

School Coordinator Salutation: First Name: Last name: Phone number: ex: 123-123-1234 School Name: Street Address: City: State: Zip code: ex: 12345, 12345-1234 School Phone: ex: 123-123-1234 Your Position at the School: What is the best way for us to contact you? : Other phone (if preferred contact method): ex: 123-123-1234 School Principal Salutation (if not you): First Name: Last Name: School District: Desired Kids Walk Month: Please note, specific date must be coordinated with local staff and volunteers : E-mail Address:

We need your email address to send you an electronic receipt and to keep you informed regarding JDRF, events in your area, and what's happening in diabetes research. If you do not wish to receive these emails in the future, please check the box below.

No thanks, just send me an electronic receipt.

JDRF values your privacy and will not share your email address with any other organization or third parties.