Survey - Volunteer Information Survey - The ALS Association DC/MD/VA Chapter

Are you interested in volunteering with The ALS Association Western Pennsylvania Chapter?

Please complete this form and we will contact you shortly. Thank you!

1.

Preferred Contact Information:

*

Name:

First Required	Last Required

*

Email: Required

Street 1:

Street 2:

City/State/ZIP:

City	State	ZIP

*

Phone Number: Required

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 - Not Required - Why are you interested in volunteering with The Chapter?

(Maximum response 255 chars, approx. 5 rows of text)

*3.

Question - Required - Indicate which areas interest you:
Please make at least 1 selection from the choices below.

	Administrative/clerical work
	Computer-data entry
	Social media/Social Media Ambassador
	Advocacy
	Photography
	Walk Planning Committee
	Walk Kit Assembly/Delivery
	Community Cares Auction Committee
	Event Day Logistics
	Securing In-kind Donations from Businesses
	Professional services (legal, HR, etc.)
	Manual labor
	Other

4.

Question - Not Required - If you indicated other, please describe your interest below:

(Maximum response 255 chars, approx. 5 rows of text)

5.

Question - Not Required - Areas of specialized training, skills, talents (i.e. crafting, planning/organizing, carpentry, photography, heavy lifting)?

(Maximum response 255 chars, approx. 5 rows of text)

6.

How often are you interested in volunteering?

(Select one of the available choices or enter a different value.)
Question - Not Required -

7.

Question - Not Required - What day(s) of the week are you typically available to volunteer?

	Monday
	Tuesday
	Wednesday
	Thursday
	Friday
	Saturday
	Sunday

8.

Question - Not Required - What time of day are you typically available?

	Morning
	Afternoon
	Evening

9.

Question - Not Required - What is your preferred method of contact?

Phone

Email

Text