Want to GIVE BACK?  

Just about everyone has been touched, or knows someone who has been touched in some way by breast cancer. Whether you’re a breast cancer Survivor, a Co-Survivor, a family member, a Komen volunteer, a race participant or just  an interested party, we want – and need –  to hear from you.

Telling your story and being a part of our video will help us to tell our story, and to get the word out about the incredible work of Susan G. Komen in Western New York.

Please fill out and submit the form below and someone will  contact you soon.

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All interviewees must fill out a release form. These forms will be supplied the day of the interview or you may bring a copy of the form with you.

[one_half][button href=”http://www.nyglobalsolutions.com/wp-content/uploads/2015/12/Release.2015-1.doc” style=”emboss” size=”medium” color=”#c41070″ hovercolor=”#e879af” textcolor=”#ffffff” texthovercolor=”#ffffff”]Download Release Form (Doc)[/button][/one_half][one_half_last][button href=”http://www.nyglobalsolutions.com/wp-content/uploads/2015/12/Release.2015-1.doc” style=”emboss” size=”medium” color=”#c41070″ hovercolor=”#e879af” textcolor=”#ffffff” texthovercolor=”#ffffff”]Download Release Form (PDF)[/button][/one_half_last]