WANTED: Change Bandits!

Register today to be a Change Bandit for Duke Children's Hospital & Health Center!

Please complete the following registration form.

Required fields indicated by *.

* Name:
* Address:
Address (continued):
* City:
* State:
* ZIP Code:
* Email:
* Phone:
* Company or Organization:
* Do you need a Change Bandits kit?	yes no
If you want to be a sheriff and lead a posse of bandits, please enter the number of kits you would like to be sent:

For More Information, Contact:

Robyn Langlois Soffera
(919) 667-2565 phone
(919) 667-0356 fax
robyn.soffera@duke.edu

Any personal information that you provide to Duke University Health System, such as your name, address or phone number will be kept strictly confidential and will not be disclosed or sold to any outside organization.

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