South Atlantic
Relay Online Help Request
Please use this form to let us know of any problem that you may be having with your Relay For Life website. Please note: if you are having issues with RelayForLife.org or Cancer.org you should contact 1-800-ACS-2345.
*Required Fields
Please provide us with information so we may contact you.
First
Last
*
1. Name:
*
2. Email:
:
*
3. Phone Number:
(with Area Code)
*
4. User Typ
e
-Select One-
ACS Staff
Relay Online Chair
Relay Participant
Relay Donor
Other
If other, how were you using your Relay Online website?
*
5. What is the name of your Relay? e.g. Relay For Life of Wicomico County
*
6. What state is your Relay in?
-Select One-
Delaware
Georgia
Maryland
North Carolina
South Carolina
Virginia
Washington DC
West Virginia
N/A
*
7. Are you a Team Captain?
Yes
No
*
8. What were you trying to do when you encountered the problem?
-Select One-
Make a donation
Start a team
Join a team
Join as an individual
Use your participant center
View the home page
Use the Event Management Center
Other (provide details below)
If you selected "Other" above please tell us what web page you were using when you encountered a problem.
*
9. Please provide a detailed description of the issue you are having. If you received an error message please include the exact text of the error message with your description.
*
10. What is the web address of your Relay For Life home page?
Additional Information
Please provide more information that may help us resolve your issue.
11. If you are a member of a team please provide your team name as it appears on the website.
12. What is your user name?
13. Please provide the full name of the person who you were trying to donate to (if applicable)?
14. Please provide the name of your American Cancer Society staff person (if known) or Relay Online Chair?
15. What type of operating system where you using when you had the issue?
Windows XP
Windows Vista
Windows 95
Mac OSX
Linux
Other
16. What type of browser were you using?
Internet Explorer 7
Internet Explorer 6 or earlier
Firefox
Opera
Safari
Other
*
17. Were you using your company's network connection when the problem occurred?
Yes
No
*
18. Are you using a dial up connection?
Yes
No
02/08/2010 09:28 PM