Global Education Program Application Form
Thank you for wanting to change the picture of breast cancer by being a part of our global effort to save lives through education and early detection. At the end of this form you will find a link to pay your membership fee. If you have any questions, please contact us at hello@knowyourlemons.com.
Email address: *
Your answer
First Name *
Your answer
Last Name *
Your answer
Are you part of an organization or an individual?
If you are part of an organization, what is your organization's name? *
Your answer
Address Line 1 *
Your answer
Address Line 2
Your answer
City *
Your answer
State/Providence/County *
Your answer
Country *
Postal Code *
Your answer
How many people do you estimate you will educate in a year about breast cancer? *
Your answer
How many educators do you estimate you will enroll in the online training course? (Available only in English) *
If you are an individual, just type "1".
Your answer
How long has your organization existed? *
What is your annual operating budget? *
What services or events do you offer? (check all that apply) *
Required
If you are an organzation, what is your annual *marketing budget* (in USD) for your programs/services for breast cancer? *
(Answer in US dollar amounts, answer "0" if you are an individual)
Your answer
Do you currently teach about more than breast cancer? *
(Such as other cancers, or other health areas?)
How many followers do you have on Facebook, Instagram and Twitter combined? *
(If you are an individual, add up your personal network.)
Your answer
What is your facebook page address?
Your answer
What is your instagram handle?
Your answer
What is your twitter handle?
Your answer
Do you teach in settings where technology isn’t available, such as a not having a projector or TV to teach with? *
Are you interested in information on using Know Your Lemons as a health promotion campaign for the general public? *
Using Know Your Lemons to promote your organization is available only to Know Your Lemons Campaign Partners. We can send you information about our campaign services and benefits.
Do you agree to report statistics on the impact you are making as a partner? This includes information such as number of people educated, location of teaching sessions and other general information. This is a key requirement of membership, and your membership will be revoked if you do not report your activities. You must accept this to be considered. *
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