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