2017 Purple Day Interest
RequiredRequired Question(s)
The Purple Day® goal is to increase the public's awareness of epilepsy and to help raise local funds for those who are affected by seizure disorders. The Epilepsy Association in Cleveland, Ohio will do its part to raise awareness and funds for the 2017 Purple Day on March 26 through grass-roots awareness and fundraising campaigns and we need the help of community members!
 
Required 1.

I am interested in getting involved in Purple Day by:


Hosting a jeans day fundraiser at my school/office
Organizing a community fundraiser/awareness event to benefit the Epilepsy Association
Sponsoring Purple Day
Having a puppet show or in-service at a school
Other  
  • Comment:

  • 500 characters left.
Required 2.
Thank you for your interest in Purple Day! Please fill out your information below and we will contact you shortly about your selections above.

First Name:
Last Name:
Company Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code: