Survey - Volunteer Sign Up - ALS United Mid-Atlantic

Volunteer Sign Up

Preferred Contact Information

Field Is Required First

Field Is Required Last

Gender:

Employment Information

Employer:

Occupation:

Street 1:

City/Town:

State / Province:

ZIP / Postal Code:

Field Is Required Email:

Phone Number:

If you respond and have not already registered, you will receive periodic updates and communications from ALS United Mid-Atlantic.

Areas of specialized training, skills, talents, (i.e. carpentry, photography)? (Maximum response 255 chars, approx. 5 rows of text)

If you speak a foreign language, list them below. (Maximum response 255 chars, approx. 5 rows of text)

Have you had experience working with someone with ALS?

Indicate which areas interest you:

Administrative/clerical work
Computer-data entry/word processing
Fundraising/special events
Media relations (write press releases, media contacts, etc.)
Other
Staffing health fairs (daytime hours needed)
Photography (newsletter, events, Walks, etc.)
Speaker's bureau
Grant writing

If you indicated other, please describe your interest below: (Maximum response 255 chars, approx. 5 rows of text)

Opportunities to volunteer with PALS (Person with ALS): (Select one of the available choices or enter a different value.) Opportunities to volunteer with PALS (Person with ALS): Click this to indicate that you will select an existing value. Tab to next input." Opportunities to volunteer with PALS (Person with ALS): Opportunities to volunteer with PALS (Person with ALS): Click this to indicate that you will enter a new value. Tab to next input." Opportunities to volunteer with PALS (Person with ALS): Provide your answer here

How often are you interested in volunteering? (Select one of the available choices or enter a different value.) How often are you interested in volunteering? Click this to indicate that you will select an existing value. Tab to next input." How often are you interested in volunteering? How often are you interested in volunteering? Click this to indicate that you will enter a new value. Tab to next input." How often are you interested in volunteering? Provide your answer here

Please indicate time of day that is most convenient for you:

What is your preferred method of contact?

Phone
Email
US Postal Service