Wigging Out For HOPE - Bring Your Own Wig - Little Pink Houses of Hope

Sign Up to Wig Out for HOPE, Bring Your Own Wig

Name(Required)

First Last

Occupation and Title as you would like it to appear on Fundraising page (Example: Vice President, United Way of Merrimack County OR Cancer Survivor and Mom).(Required)

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

The following best describes me (choose all the apply)(Required)

I am a breast cancer survivor

I am a cancer survivor

I am honoring someone who has or has passed away from cancer

I attended a Little Pink retreat as a participant/ family member

I serve as a Little Pink Volunteer

I am a Little Pink Corporate Sponsor

I am supporting Little Pink from one of its Retreat Locations

I am excited to be getting involved for the first time

Age(Required)

Gender

Race

As an amabassador for Little Pink you will be mailed a tshirt. What size would you like?(Required)

Wig Choice(Required)

Are you interested in getting friends or family involved? This is a great project to do together or even compete! Please list THEIR NAME, EMAIL, and PHONE of individuals that you would like to nominate to be a BIG WIG with you and we will reach out to them! (click on the + button to add people)

Name

Phone

Tell us about your WHY! Your supporters will connect with your story and be more likely to support your efforts if they understand WHY you have chosen to be a part of Wigging out for HOPE. This information will be used on your fundraising page.

Are you dreaming bigger? Tell us about any ideas that you might have with which we can be of assistance:

A fundraising goal of $1,500 has been set for each individual. To honor your intentions, please choose one of the following:(Required)

Please upload a headshot or up close picture of yourself to be used to create your fundraising page. It will be used as a placeholder until we have your BIG WIG picture.

Max. file size: 50 MB.