Children’s Miracle Network Hospitals Telethon VIP Panel Registration :: Nationwide Children's Hospital

Children's Miracle Network Hospitals Telethon

VIP Panel Registration

Thank you for your interest in serving on the 2013 Children’s Miracle Network Hospitals Telethon VIP Panel. The CMNH Telethon will air live on WBNS 10TV June 1st & 2nd. Please select the top three day and time slots you prefer to serve as a VIP panelist. You will receive confirmation of your assigned time slot by email.

Please register for the VIP Panel
Name (List as you would like to be introduced and the way your nameplate should read) *
Title
Company *
Company Address *
City *
State
Zip Code
Work Phone *
Home Address
City
State
Zip Code
Home Phone
Email Address *
Please select your first choice of date and time. *
Please select your second choice of date and time. *
Please select your third choice of date and time. *
Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000