Fresh Air Alumni Form | The Fresh Air Fund

First Name

Last Name

Do you have a different name now than you did when you participated? If so, please share:

Date of Birth

Email Address

Phone

Mailing Address

Street Address

City

State

Zip

What Years did you participate?

Start

End

What Program did you participate in?

Please select any of the opportunities you are interested in:

Volunteering	Fundraising
Reconnecting with my Host Family	Networking with other Alumni

Do you have a Fresh Air story you’d like to share?

I am interested in being interviewed about my Fresh Air experience :

Yes