We're counting on you!

1.

Please enter your contact information below:

*

Name:

Title	First Required	Middle Required	Last Required	Suffix

*

Email: Required

Street 1:

City/State/ZIP:

City	State	ZIP

*

Phone Number: Required

Yes, I would like to receive e-mail from The ALS Association Florida Chapter

Yes, I would like to receive postal mail from The ALS Association Florida Chapter

2.

Question - Not Required - How should we contact you?

Email

Phone

3.

Question - Not Required - At which Walk location would you like to volunteer?

4.

Question - Not Required - How would you like to help?

	Walk Committee Volunteer
	Pre-Walk Volunteer
	Walk Day Volunteer

5.

Question - Not Required - If you are interested in serving on one of our Walk Committees, please indicate your area of interest:

	Corporate Sponsor Committee
	Corporate Team Committee
	Family Team Committee
	Logistics Committee
	Volunteer Committee
	Food & Beverage Committee

6.

Question - Not Required - If you are interested in becoming a Pre-Walk Volunteer, please indicate your area of interest:
Please make at least 1 selection from the choices below.

	Donation Entry
	Donor Thank You Calls
	Kick Off Party Follow Up Calls
	Physical Mailings

7.

Question - Not Required - If you are interested in becoming a Walk Day Volunteer, please indicate your area of interest:

	Set-Up
	Registration/Greeting
	Accounting
	Walk Route Monitors
	Checkpoints
	T-Shirts
	Advocacy
	Clean-Up

8.

Question - Not Required - How did you hear about our Walk Volunteer opportunities?

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

Alabama Walk Volunteer