Come join the Celebration! Help us honor our Global Health Teams and support the programs the champion in Haiti.

 

CELEBRATION REGISTRATION FORM

Event Ticket per person: $150. Please indicate the number of tickets you would like and the names of your guests, if any.

Guest Name(s)
Unable to Attend
  • I am unable to attend but please accept our tax-deductible contribution in support of HUFH's work.

Sponsorship Opportunities

 

I want to be an event sponsor. Please list my name, medical practice and/or business as follows:
Please Choose Your Sponsorship Level
  • Diamond Sponsor - $2500
  • Platinum Sponsor - $1000
  • Gold Sponsor - $500
  • Silver Sponsor - $250

Program Support

Help support our resident-led programs in Haiti.
  • General Support
  • Cervical Cancer Screen & Treat
  • Pediatric Outreach & Programs

Total Donation

Donation Amount*
$

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

 

 

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments