Weighing In Directory Member Directory

To become a member of Kansas City's Childhood Obesity Prevention Collaborative, Weighing In, please submit your contact information using the on-line form below. There is no fee for membership, simply the desire to impact childhood obesity in order to improve health of children in the Kansas City area.

We welcome your membership!

You will automatically be added to the Member Contact List and/or Member Agencies Search page according to the information you provide.

Please note: By submitting your request via this online form, you authorize your information to be placed on member contact and search agency webpages.

Check here if you do not want your contact information to be listed:


First Name MI Last Name

Credentials
 
Title
Organization
Address
City
State
Zip
County(s)
Email
Please submit all phone numbers in the following format: XXX-XXX-XXXX
Primary Phone
Secondary Phone
URL
The following categories describe my organization (if applicable):
Please Specify if you selected Other:

 

The following categories describe my profession:
Please Specify if you selected Other:

 

I'm interested in the following working groups:

 

I'm interested in the following topics (choose up to 3 interests):
Please Specify if you selected Other:

 

Please provide a brief program description of your organization.
(250 characters)

First and last name, email address, and primary phone are required.

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