Rooted In Life – Request Form

The 'Rooted In Life' awareness campaign aims to increase awareness about the need for organ, eye and tissue donation in the Black community by featuring the stories of National Pan-Hellenic Council members whose lives have been touched by the gift of donation.


Rooted In Life Display: Things to Know

Thank you for your interest in our "Rooted In Life" campaign. This link provides you with additional information regarding our campaign materials and how you can use them in your community.


Contact Information

Phone

Street Address, City, State, and ZIP code


Display Details

How would you like this campaign featured in your community?

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How often will this campaign be featured in your community?

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How would you like this campaign featured in your community?

In the event that the start date for the banner you requested is unavailable, can you provide us with an alternative start date?


Physical Displays

Click this link to view the Rooted In Life banners.

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Where do you plan to place the display? (Please note: Banners are 8 ft tall and 3.5 ft wide)

On average, how many people in your community access this area daily?

How would you like to receive your display?

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Please provide the address in which the banner will be displayed.

Disclaimer: Deliveries can not take place at a personal residence.


Digital Displays

Please select the digital materials that you would like to feature.

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How will this digital campaign be featured in your community? (i.e. newsletter, webpage feature, email, etc.)

How many people in your community will this digital display reach?


Additional Support Materials

Lifeline of Ohio is pleased to offer the following educational items, free of charge, to support you and your community while you host the 'Rooted In Life' display.

Please select the materials you'd like us to provide with your display.

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Please provide any additional details or requirements related to the display that would help us meet your needs and expectations:


Thank You for Your Request

We are excited to see that you are interested in hosting our Rooted In Life campaign and look forward to fulfilling your request!


Once your request has been received, we will follow up with you regarding availability and next steps.


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