Reserved Seating Incentive
If your chapter has contributed service hours or monetary donations towards the American Cancer Society, fill out this form for a chance to win reserved seating at one of the sessions at the 2019 State Conference!

Winners will be notified before the conference!

Email Address *
Your answer
Chapter Name *
Your answer
Advisor Name *
Your answer
Advisor Email *
Your answer
School Street Address *
Your answer
City *
Your answer
ZIP Code *
Your answer
Contact Phone *
Your answer
Number of Reserved Seats Desired *
Your answer
Dollars Raised by TSA Chapter for the American Cancer Society (May 1st, 2018-April 1, 2019) *
Your answer
Estimated Service Hours Contributed by TSA Chapter for the American Cancer Society (May 1st, 2018-April 1, 2019) *
Your answer
How has your TSA Chapter fundraised for the American Cancer Society? *
Your answer
What impact has the American Cancer Society had on your TSA Chapter? *
Your answer
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