Class of 2025 Nomination Form

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Class of 2025 Nomination Form

Thank you for your interest in the American Heart Association's Teen of Impact program. This exclusive program empowers teen leaders to use their influence to fight the #1 killer in our country, heart disease.

Winners in each market last year raised between $10,000 to $50,000 each depending on the city / state their were competing in!

To nominate a young changemaker, complete the form below and we will reach out to schedule a 30-minute Zoom call with the teen and their parent(s) to learn more.

Teen Name *

Teen Email

Parent 1 Name *

Parent 1 Email *

Parent 2 Name

Parent 2 Email

Phone Number *

What city is the teen in? *

Nominator Name & Relationship to Teen *

Nominator Email *

How did you hear about Teen of Impact? *

Please include a bit of information about why you are nominating this teen and why you think they would make a good Teen of Impact nominee. *

Name of person filling out this form *

Name of AHA contact (if applicable)

Submit

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