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Pen Pal Registration Thank you for your interest in becoming a JDRF Kids Online pen pal. Please complete this form and click "submit" when finished. Only your first name, age, state/country (if provided), and profile text will be posted to the bulletin board. You may wish to include the following in the text of your profile: diabetes thoughts and concerns; favorite hobbies and activities; family members and pets; and any other interesting information you would like to share.

Note: Highlighted fields indicate required information.

* Required field  
* First Name:
* Last Name:
* Email:
* Email Confirmation:
* Birthday: ex. mm/dd/yyyy
* Relationship to Diabetes: I have diabetes
Family or friend has diabetes
State/Province:
Country:
* About You:
(1000 character max)
  Want to include a personal photo with your profile? Browse your computer and select a photo.
Kids Advocacy Network I would like to join JDRF’s Kids Advocacy Network and help to raise awareness on important diabetes issues.
Sign me up!
 

Any submissions to the Pen Pal bulletin board constitute permission for posting on the Web site as well as for publication within C.F.K. Magazine.