Becky Carney Application

The Lucky Hearts Campaign is currently accepting applications for the Becky Carney AED Initiative. The initiative will be donating a total of 20 AED’s in Becky Carney’s honor to deserving organizations within Mecklenburg County.

The Lucky Hearts Campaign would like to recognize all the companies that contributed to the Becky Carney AED Initiative. Your generosity and support will truly make a difference in the community. Please click here to view a complete listing of the Becky Carney AED Initiative supporters.

If you wish to apply for an AED through this program, your organization must meet the following criteria:

Mecklenburg County-based house of worship
Serve a population of largely at risk of health disparity or poor health outcomes
Demonstrated need (large congregation, limited financial resources, etc)

*If your organization does not meet the criteria stated above, you can still apply for an AED through the Lucky Hearts Campaign under General Applications.

To apply, please fill out all required information below. A member of the Lucky Hearts team will contact you to let you know if your application was approved to set up an initial meeting or they will let you know if you were not selected by the program.

If you have any questions, please feel free to email Kristin Young, Medic Public Relations Coordinator.

Nominated Organization *

Main Contact Name *

Day Time Phone *

Evening Phone *

Main Contact Email Address *

Street Address *

City *

State *

Zip *

Is your organization a house of worship? *

Number of Employees *

Number of Members *

Does the organization currently own an AED? *

If yes, how many AEDs? *

Has the nominated organization offered CPR/AED training for employees/members? *

Why or Why Not? *

Is the nominated organization willing to hold 2 (90 minute) CPR/AED awareness training seesions during normal business hours? *

If not, when would be a more convenient time? *

AED Nomination Recommendation *
Briefly explain why the nominated company should receive an AED and CPR/AED training.

Nominator Name *

Nominator Phone Number *

Nominator Email Address *

Street Address *

City *

State *

Zip *

Employer *

(*) denotes a required field.