PANHANDLE BREAST HEALTH

301 South Polk Street, Suite 740

Amarillo, Texas 79101

806.331.4710

© 2018 | All Rights Reserved  |  Panhandle Breast Health  

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EXECUTIVE

DIRECTOR

 

Your Application has been Submitted!

WHAT YOU NEED TO KNOW

The Bright Lights of Bra-Way (BLBW) is the primary fundraiser for Panhandle Breast Health (PBH), a non-profit organization providing breast health education and navigation for essentialbreast health services for Panhandle women. Proceeds from this fundraiser will benefit PBH, and in turn, women throughout the Panhandle of Texas. The event and all functions related to it are intended as a benefit.

To participate in The Bright Lights of Bra-Way you must be eligible according to the Eligibility Guidelines. Secondly, you must agree to stipulations stated in the Model Agreement Form submitted with this application.

Submission of a signed Model Application Form constitutes your agreement and compliance with these Eligibility Guidelines. The initialed Model Agreement form is also required.  In addition, by signing this Application Form you are agreeing that pictures and videos taken for and during your participation as a Model are the property of PBH to use at its discretion for promotion purposes as long as BLBW is offered.

Applications are accepted on a first come, first served basis. Preference will be given to those who have been associated with PBH in some significant way, secondly to new friends as of January 2018 and lastly to breast cancer who are active members of our community and strongly wish to participate. This year BLBW will accept 25 Models.

The application period will close at 5:00 pm on June 3, 2019 or sooner if the number we receive surpasses the number we can accept,

We kindly ask each Model to commit to serving as a Model for two consecutive years. Although this two-year commitment is not a requirement, we hope to rely on our returning Models to help guide and mentor next year’s newcomers. 

The Model Application includes:

1. Application (link below)
2. Agreement Form (link below)
3. Medical Release Form*   (required only for survivors who are within five years of treatment or are currently in treatment) 
*Survivors who are within five years of treatment or are currently in treatment (defined as chemotherapy, radiation, surgery) are required to submit a signed release from your doctor indicating the level at which it is safe for you to participate. If you have not been in treatment for more than five years, you are exempt from having to provide a medical release.

Important: Most doctors do NOT require an appointment before completing your Medical Release Form. Please check with your doctor’s office to confirm this. All forms can be delivered to PBH through one of three ways:
— email: pbhadmn@PanhandleBreastHealth.org
— mail/hand-delivery: 301 S. Polk, Suite 740, Amarillo Building - Use North Elevator 
— fax: 806-337-1702 Attention PBH

If you have questions or concerns regarding your medical release form, please email Leticia at Leticia@Panhandlebreasthealth.org  or Becky at pbhadmn@Panhandlebreasthealth.org. 

BLBW MODEL FORMS: 

Model Application (submit online)

Model Agreement   (submit online)


Medical Release   (print and complete)

Call for Model Applications opens March 21, 2019. Your application may result in your becoming one of a lively group of women having fun as BLBW Models.

Thinking about serving as a Model but have some questions? Check out our Model FAQ page to see if your questions have already been answered.

If you don’t see your question answered, send a message topbhadmn@Panhandlebreasthealth.org and someone will be in touch with you shortly.