COTA Partner Registration Form

The Children’s Organ Transplant Association is very grateful that you are planning a COTA activity. Please complete this form and click send so COTA can add your activity to the list of COTA events being planned across the country.

Thank you for Giving Hope and Making Miracles!

*Required information

First Name: *
Last Name: *
Organization or Company Name: *
Number of members/employees: *
Your Position:
Address: *
City: *
State: *
Zip Code: *
Email: *
Phone: *
Your COTA Activity Plans
Date of Activity: *
Location of Activity: *
Description of Activity: *
Number of people you expect to attend your activity: *
Cost for participants: *
Number of volunteers you will need: *
Number of donors you would like to add to donor list(s): *
Media coverage planned: *
Amount you plan to raise: *
How did you learn about COTA?: *
Do you know what to do with funds after your activity?: *
Are you aware of the COTA resources available to you?: *

COTA video plays here.

Alison Kirk

Making Miracles:

“At birth, we were given little hope Major would ever leave the hospital. Then a transplant center 1,800 miles away from home gave us hope … and COTA helped turn that hope into a miracle. COTA gave us a sense of peace about the financial aspects involved with Major receiving his father’s kidney.”

COTA MIRACLE MAKERS

COTA

GIVE HOPE

MAKE A MIRACLE

COTA Partner Registration Form

Your COTA Activity Plans

Making Miracles:

Karroll and Stephanie Key