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Outreach Request


To request a representative, educational materials or breast health presentation at your organization, event or health fair, please fill out this form at least 3 weeks in advance of your proposed date. We will try to accommodate all requests, however fulfillment of the request is not guaranteed and is based on availability. Please contact Kendall Bode as soon as you are able if any of the information below changes.

Breast health presentations are conducted by the community outreach team and volunteers. These volunteers are Komen Education Ambassadors who are trained, skilled and enthusiastic speakers who are ready to spread the word about the fight against breast cancer through free breast health presentations in English and Spanish. Please note that only requests within our 13-county service area can be considered.  Also as following our policy, we are unable to participate in events which charge a fee for non-profit participation.

For more information or questions please contact: 

By Phone: 704-347-8181 or By Email: outreach@komencharlotte.org

Question - Required - Today's Date

2. Contact Information:



















(Maximum response 255 chars, approx. 5 rows of text)


Question - Required - Event Date (At minimum must be three weeks from today)






(Maximum response 255 chars, approx. 5 rows of text)

  Please describe the demographics of the expected event attendees:




18. Language preferred
(Select one of the available choices or enter a different value.)


Question - Required - Support Requests (While our goal is to fulfill all requests, volunteer and staff availability on event dates and location will be considered)


Komen Table Requests:




Speaker Request:




   Please leave this field empty