MLH-LI Coordinator
longislandny@mendedlittlehearts.org
Please enter the following information:
First Name
Last Name
Phone
Address
Birthdate
City
Email *
State
Zip
First Name of Heart Child
CHD Diagnosis
Other Children / Birthdate
Type of Surgery
Date of Surgery/Procedure
I am interested in Bringing snacks to the meetings Helping to plan special events Fundraising Networking with other parents/categories
Comments/Suggestions:
