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Volunteer Registration Form

1. Please enter your primary contact information:

If you have previously registered, please 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 - Not Required - Preferred way to contact you:

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6. How did you hear about the National MS Society?
(Select one of the available choices or enter a different value.)



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Question - Required - Please select which type(s) of volunteer work interest you:

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Question - Required - Please select any skills you wish to share:

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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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