Volunteer Survey - The ALS Association

Are you interested in a volunteer opportunity?

Please complete this online interest form and we will contact you shortly.

1.

Preferred Contact Information:

If you have previously registered, please to prepopulate your information.

*

Name:

Title	First Required	Last Required

*

Email: Required

*

Street 1: Required

Street 2:

*

City/State/ZIP:

City Required	State Required	ZIP Required

Phone Number:

Employer:

If you respond and have not already registered, you will receive periodic updates and communications from ALS Association - DC / MD / VA Chapter.

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*2.

Question - Required - Indicate which areas interest you:

	Walk to Defeat ALS
	Special Events (Dine to Defeat ALS, Dinner Gala, Community Fundraisers)
	Workplace Giving Fairs
	Office Help
	Care Services

3.

Question - Not Required - What is your relationship to ALS?