Nominate an Ambassador

You can nominate a leader in your community - or nominate yourself - by completing the information below. A member of our team will follow-up with your nominee soon to collect additional details.

A ResearcHERS Ambassador commits to:

Raising at least $2,500 to help the American Cancer Society sustain the funding of female cancer researchers
Spreading the word to increase awareness of the ResearcHERS program and purpose
Encouraging other women to join the ResearcHERS program

Your Information

First Name:

Last Name:

Company (optional):

Title (optional):

Email:

Phone:

Nominee's Information

First Name:

Last Name:

Company (optional):

Title (optional):

Email:

Phone:

City:

State:

Additional Information

Is the nominee aware they are being nominated?

Yes No

Is the nominee aware that the American Cancer Society will be following up on their interest in the campaign?

Yes No

Would you like to kickstart your fundraising by making a donation?

Your team name last year.

This team doesn’t have a leader.
Would you like to lead the team or join the team?

This isn’t what I wanted.

Do you have a discount code? (optional)

Could help provide free access to 24-hour information and support via phone, email, and online chats for one person.

Could help provide free access to 24-hour information and support via phone, email, and online chats for two people.

Could help provide 8 rides to and from treatment for a breast cancer patient with our Road to Recovery® program.

Could offer a cancer patient and their caregiver one night of free lodging at a Hope Lodge® location.

Any donation amount helps save lives from breast cancer.

Cancer has touched all of us in some way. And we want to stop this disease in its tracks. We'll spend the next few weeks fundraising for the American Cancer Society. Then, on the day of the event, we'll honor the lives lost to cancer, celebrate survivors, and support the caregivers who so selflessly help others.

Together, we'll be a part of making a difference in this important cause.

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Please enter at least three letters of the city name.

Please choose a state.

Please enter at least three letters of the event name.

Please enter at least three letters of the team name.

Please enter at least three letters of the first or last name.

City

Zip Code

First Name

Team Name

Enter First Name

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209329

ResearcHERS

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213923