Submission for Faces of YLC – Young Lung Cancer Initiative

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Submission for Faces of YLC

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Information of person you would like to honor

First Name for Faces of YLC

At what age were they diagnosed?

Example put "40" for "Diagnosed at 40"

State

If you do not live in the US, please list where you are from

Photo upload

Click or drag a file to this area to upload.

Please upload a good headshot of their face with nobody else in the photo.

Submitter's name and information

Name

First

Last

If you would like to share more of your story with others - please provide us with a little more information about what you feel is you'd like others to know or learn from your journey & someone from our team will contact, you in the near future?