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Volunteer Application Form

  Please provide your contact information and areas of interest.

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

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Name:

 

 

 

     

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City/State/ZIP:

 

    

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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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Question - Required - Preferred Number to call you:



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Question - Required - Preferred way to contact you about National MS Society:



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Question - Required - How did you hear about the National MS Society?








   


 

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

 

 
Question - Not Required - Interests: Please check which type(s) of volunteer work interest you.

   


 
Question - Not Required - Skills: Please check any skills you wish to share.

 
Question - Not Required - Education: Please check you highest education level completed.

 

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

 

 
Employment

   


 


   


 

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

 

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

 


   


 


 

References: (please use two non-family members as references)

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

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

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Emergency contact information:

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Question - Required - Please read the following carefully before clicking the Submit Application button below. By submitting this application, I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with the National MS Society that is true, correct, and complete to the best of my knowledge. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with the National MS Society or my termination as a volunteer. 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.

  Optional: Please indicate your racial/ethnic group.
(Select one of the available choices or enter a different value.)



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