Survey - Indiana Walk Volunteer - The ALS Association Indiana Chapter

Indiana Walk Volunteer

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

If you respond and have not already registered, you will receive periodic updates and communications from The ALS Association.

2.

Question - Not Required - How should we contact you?

Email

Phone

3.

Question - Not Required - While the walk will be hosted in the Indianapolis area, we are looking for volunteers all across the state to help activate initiatives on walk day. Please choose where you can offer assistance:

4.

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

	Walk Committee Volunteer
	Walk Day Volunteer

5.

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

6.

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

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