2014 Volunteer Application

1. Please enter your information:

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

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Date of Birth:

 

 

 

What's this?

Please enter a username and password that you can use when you return. You can use this password to update your information or receive personalized content.

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5 to 60 characters

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5 to 20 characters

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Availability

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Question - Not Required - If able to work weekdays, what days are best:

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Question - Required - If interested in volunteering at one of our special events, please select your preference for volunteer shift(s). Note that times are estimated.

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Emergency Contact

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Additional Information

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

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Question - Not Required - What types of volunteer activities are of interest to you? (check all that apply)

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Question - Not Required - Do you have training or extensive experience in any of the following areas? (check all that apply)

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Question - Not Required - Please select any of the following computer skills you possess:

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

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To the degree I may be given access to the identity and details of persons with Multiple Sclerosis and their families, as well as to donors’ names and giving history, I will treat this information in strict confidence. I also recognize that the Chapter’s staff will provide continuing direction and counsel to me as to the proper use of confidential information.

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