Join a Team

You can help improve children's nutrition and physical activity in your state by joining other leaders on your Action for Healthy Kids Team.

Please complete and submit this form so we can share your contact information with your Teams leader(s), who will be in touch with you about how to get involved. We will not sell or share your information with any organization or outside parties. Please read our privacy policy.

*Team:
*Participation
Level:
I want to become a member of a Team (get involved in Team activities)
I am interested in INFORMATION ONLY (receives Action for Healthy Kids monthly e-newsletter)
*First Name:
*Last Name:
*Organization:
*Title:
*Address Line 1:
Address Line 2:
*City:
*State:
*Zip:
*E-mail:
Day Phone: x
Evening Phone:
*I best represent
(Stakeholder):
I am affiliated
with these
Collaborators:
(select up to 6)