Company Sign-up Form

Fields marked * require an entry.

THANK YOU!
Thank you for choosing to donate your employees' time, talent and treasure to our mission. Your support is helping to save and improve lives within our community and beyond.

Turn your time into treasure!

Does your company offer Dollars for Doers?
Many companies offer dollars based on the number of hours their employees volunteer. Taking these simple steps could potentially drive revenue for your community’s Heart Ball campaign by allowing the AHA to receive dollars based on volunteer participation.

Check to see if your company offers Dollars for Doers and how many volunteer hours are needed. Visit www.heart.org/matchinggifts and scroll to the bottom of the page to see if your company offers these dollars.

Sign-up your company to participate in your community’s Serve Day and invite other companies to join you by asking their employees to participate in volunteer activities that will count toward Dollars for Doers guidelines and submit their hours to donate to the AHA.

I accept AHA's Terms of Service and Privacy Policy :*

Yes

My Company Name:*

My company offers Dollars for Doers:*

Yes

No

My company is interested in these Community Serve Day activities:*

AHA Gratitude Volunteer Activity

Virtual Hands-Only CPR Awareness Activity

Hands-Only CPR In-Person Event **See note above

Healthy Food Drive

Blood Pressure Awareness Challenge

I will be the Volunteer Project Lead:*

Yes

No

If you answered no above, please fill in name and contact information for the Volunteer Project Lead:

Volunteer Project Lead Job Title:*

Local Heart Ball Name:*

Date of Activity:

Contact Information

Company:

First Name:*

Middle Name:

Last Name:*

Address:*

Address2:

City:*

State:*

Postal Code:*

Country / Location:*

At least one phone number is required.*

Mobile Phone:

Work Phone:

Email:*