Speak Only with Your Heart 2020

Get Involved

Please complete this form to indicate how you would like to participate in our 2020 Speak Only with Your Heart Campaign this month! Your participation will bring awareness, acceptance, and critical funding to allow us to continue supporting students and families experiencing complex communication challenges in innovative ways during the 2020 COVID-19 pandemic.

Question Title

* 1. How would you like to participate?

VOLUNTEER to give up my voice for 12 hours, or until I meet my fundraising goal by soliciting donations.

NOMINATE SOMEONE to give up their voice for 12 hours, or until they meet their fundraising goal by soliciting donations.

DONATE to this campaign to support the programs of Optimal Rhythms.

SPREAD THE WORD about this campaign to encourage others to Speak Only with Your Heart.

Question Title

* 2. Please provide your contact information:

Full Name

Company (or N/A)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 3. If you chose to NOMINATE someone to "Speak Only with Your Heart", please provide the name and contact info for your NOMINEE here:

Full Name

Company (or N/A)

City/Town

State/Province

Email Address

Phone Number

Question Title

* 4. If you chose to VOLUNTEER, please indicate a date (between October 24-30) you would like to begin your 12 Hours of SILENCE:

Date/Start Time

Date

Time

AM/PM

Thank you so much for your participation in Speak Only with Your Heart 2020!! You are truly making a difference and giving a voice to a child who longs to be heard. We will be in touch soon with more information.