Create a Corporate Team

Your company has the chance to help raise awareness about the importance of lung health and play an important role in our finding a cure for lung cancer and lung disease by becoming a Corporate Team.

If you would like to learn more about this opportunity, please fill out the form below and someone from the American Lung Association will be in touch with you soon.

*Required fields are marked with an asterisk

Question - Required - First Name

Question - Required - Last Name

Question - Required - Email Address

Question - Not Required - Street 1

Question - Not Required - Street 2

Question - Not Required - City

Question - Not Required - State

Question - Not Required - Zip Code

Question - Not Required - Phone Number

Question - Not Required - Employer

Question - Required - Interest (check all that apply)
Please make between 1 and 2 selections from the choices below.

	Fight For Air Climb Local Corporate Team
	Fight For Air Climb National Corporate Team

Question - Not Required - Please provide any additional information you would like us to know regarding your company's interest in becoming a Fight For Air Climb Corporate Team:

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

Question - Required - Enter the letters as they appear below:

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Create a Corporate Team

Register Today!

Recreate Team from Last Year

Register as a New Team Captain

Register as a Team Member

Register as an Individual

Register as a Volunteer