By checking the “agree” box below and submitting this application, I am indicating my understanding, consent and commitment to provide an impact statement and to participate in a published story as described below.
I understand the information securely collected in this form will be used only for purposes of this application processes.
I understand this application and the contact information provided by me will not be shared or used for any purpose other than as related to this award.
If I am a client / client family, I understand my application for this award will have no impact on any current or future TVCC service.
I understand that a public story and any impact statements related to this award will include my name and photos of me if I am an award winner. These stories, photos and statements may be published in the TVCC annual report, appear on TVCC social media channels and on the websites of TVCC and / or Children’s Health Foundation, the official Fundraising partner of TVCC.