Check Screen Reader Mode to make this survey compatible with screen readers.
Check Screen Reader Mode to make this survey compatible with screen readers.

HeartSmarts Community Education Series 2026

Registration HeartSmarts Community Education Series 2026

Registration HeartSmarts Community Education Series 2026. The zoom link will be sent by 5:30pm (EST) the day of the event.

PLEASE READ THE QUESTIONS CAREFULLY AND MAKE SURE TO CHECK YOUR EMAIL ADDRESS. IF THE QUESTION SAYS LEAVE IT BLANK, DO NOT TYPE N/A.JUST LEAVE IT BLANK.

DO NOT REGISTER FOR ANYTHING YOU ARE NOT INTERESTED IN.
1.First and Last Name(Required.)
2.What is today's date?(Required.)
Date / Time
3.Enter the email address to receive zoom link for event below. Double check the email address to ensure it is written correctly.(Required.)
4.How did you hear about this event?(Required.)
5.Are you located in the New York Tri State Area?(Required.)
6.If you are in the NY Tri-state area, which borough, location, or state are you in?(Required.)
7.If your church is in the NY Tri-state area, which borough, location, or state is it in?(Required.)
8.If you are NOT in the New York Tri-State area, where are you located (City and State)? If you ARE in the New York Tri State area, type N/A.
(Required.)
9.If you would like more information about programs for HeartSmarts program members, enter your email address below. If not, leave it blank. DO NOT TYPE N/A.
10.If you would like more information about becoming a HeartSmarts Ambassdaor enter your email here (you do not have to be in the NY Tri State area). If not, leave it blank. DO NOT TYPE N/A.
11.If you host community health fairs or programs in the NY Tri State area and would like HeartSmarts to have a table, enter your email address here. If not, leave it blank. DO NOT TYPE N/A.
12.If you would like to bring the HeartSmarts Sprouting program sponsored by HeartSmarts and Doug Evans, author of the Sprout Book, to your church or community group (you do not have to be in the NY Tri-state area), enter your email below. If not, leave it blank. DO NOT TYPE N/A.
13.If you would like to join the next HeartSmarts Part 1, 7 Steps to a Health Heart Class, enter your email address in the space below. If not, leave it blank. DO NOT TYPE N/A.
14.If you would like to become an official member of the HeartSmarts program, enter your email in the space below. If not, leave it blank. DO NOT TYPE N/A.
15.If you would like to participate in the HeartSmarts Food for Life Series sponsored by the Physicians Committee on Responsible Medicine, enter your email in the space below. If not, leave it blank. DO NOT TYPE N/A.
16.If you are located in or connected to community organizations or churches in Crown Heights, Brooklyn, please enter your email address here. If not, leave it blank.
17.If you are located in or connected to community organizations or churches in University Heights, Bronx, please enter your email address here. If not, leave it blank.
Current Progress,
0 of 17 answered