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# of Hoosiers registered to Donate Life:



Organ Donation Awareness Challenge
Intent to Participate Form

You have been invited to participate in Donate Life Indiana’s annual app challenge to help raise awareness surrounding organ, tissue and eye donation and transplantation. If you are interested in participating, please fill out the below form.

    I submit our chapter or club’s intent to participate in Donate Life Indiana’s annual organ donation awareness challenge. I understand that the main goals for our group to participate are:

    • signing up new organ donors
    • completing awareness activities (see ideas on the App Challenge pdf or by downloading the app)

    I understand that the challenge will have an announced begin and end date, which is the only time students can sign up individuals and submit activities. I provide my consent for pictures and videos submitted through the app to be used for the purpose of increasing public education of the need for organ and tissue donation.

    If you are a group that would like to participate or if you have any questions, please contact your challenge lead:

    Andi Amburgey Atherine:
    Corinne Osinski-Carey: