Campaign Sign-On Form

Keep Up The Rates Campaign Supporting Organization Sign-On Pledge

As a supporting organization for the Keep Up The Rates campaign, our organization agrees to support and amplify the goals of the campaign to ensure optimal use of vaccines currently available to protect all individuals in the US. By completing this form, I certify that I am an authorized representative of the organization and agree to allow the organization’s name and logo to be used on campaign materials, including the NFID website, social media channels, and press releases.
Name of Organization (as it should be listed) *
Organization Website *
Organization Twitter Handle
Name of Authorized Representative *

First Name Last Name
Title of Authorized Representative *
E-mail Address of Authorized Representative *
Phone Number

Area Code Phone Number
State *
Upload high-resolution file of organization logo (minimum 250x100 pixels) *

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Keep Up The Rates Campaign Supporting Organization Sign-On Pledge