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NCT Service Project Volunteer Application 2012.13

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Interests and Skills



Question - Required - What is your relationship to MS?

Question - Required - Which city will you be volunteering for a Service Day Team?




Question - Not Required - Please check the types of other volunteer activities that interest you (check all that apply):
Please make up to 9 selections from the choices below.



In consideration for my participation in the What a Difference a Day Makes:  Service Day program, I freely accept and voluntarily assume the risks of personal injury or property damage that may arise as a result of my participation. 

In addition I further agree to hold harmless the National MS Society, corporate sponsors, cooperating organizations and all parties connected with this program activity from any liability as a result of my participation. I will permit emergency treatment in the event of injury or illness while participating and give permission to use my name and photo taken of me during the event in any promotional material, publication, or on the website. I understand that the National Multiple Sclerosis Society withholds the right to dismiss anyone that may cause disturbance or deliberately disregard established rules and guidelines.  I certify that I have read and understand the intent of this waiver and release.

Question - Required - I agree with and understand the Volunteer Consent information listed above. If you are under 18 years of age you must return a parent/guardian signed consent form.



All members of the National and Chapter boards, leadership volunteers and staff shall:
1. Authorize the use of the name, emblem, endorsement, services, or property of the National Multiple Sclerosis Society only to advance the mission of the Society and in conformance with Society policy.

2.  Seek financial or other resources in the name of the Society, in the best interests of the Society.    No trustee, leadership volunteer, or staff member shall accept personal gifts or gratuities (other than very small, inconsequential benefits) from a supplier of goods, equipment or services. 

3.  Not knowingly take any action or make any statement intended to influence the conduct of the Society in such a way as to confer any financial benefit on such person or any corporation or entity in which the individual has an interest or affiliation. Trustees, leadership volunteers and staff shall scrupulously avoid any conflict between their own respective personal, professional or business interests and the interests of the Society.   Among other circumstances, potential conflicts of interest may exist whenever a trustee, a leadership volunteer or staff member, or an employee of such person or a member of his or her family has an interest in a business transaction or proposed transaction involving the Society.

4. Use association with the Society in public events only to advance the mission of the Society.  No trustee, leadership volunteer or staff member shall publicly utilize any Society affiliation in connection with the promotion of partisan politics, religious matters, or positions on any issue not in conformity with the position of the Society;

5. Maintain the confidentiality and privacy standards of the Society.  No trustee, leadership volunteer or staff member may disclose or reveal or use confidential or proprietary information of the Society or its clients without express authorization.

6.  Not use information regarding or acquired as a result of Society relationships with corporations, or government agencies, or their employees or other sources to buy, sell, or otherwise make transactions of stock, securities or other assets of corporations, their subsidiaries, parents, or competitors or otherwise act for personal benefit or gain themselves or their relatives, friends or business associates.

7.  Periodically affirm in writing upon request of the President of the Society or its Chapters that he or she has received, read and understands and agrees to be bound by this Code of Conduct.

Question - Required - This Code is intended to help members of the National and Chapter boards, other leadership volunteers and staff avoid situations that could compromise the integrity and independence of the Society's decision-making processes, or compromise the Society's reputation or public confidence in the Society. NOT AGREEING TO THE CODE OF CONDUCT WILL DISQUALIFY VOLUNTEERS.


 Confidentiality Statement 


To the degree I may be given access to the identity and details of persons with multiple sclerosis and their families or other confidential business of the Society, I agree to safeguard such information in strict confidence. I also recognize that the chapter programs director, or her/his designee, provides continuing direction and counsel as to the proper use of confidential information.


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