The time is now to defeat ALS!

Team Name	Event Name	Gift Amount	Members Recruited
2014 Ice Bucket Challenge for ALS	2014 ONE DOLLAR DIFFERENCE EVERGREEN CHAPTER	$118,657.88	5
Team PVO, Positive Vibes Only	Walk to Defeat ALS Boston	$108,773.59	150
Team Limp Broozkit	Walk to Defeat ALS Washington DC	$85,959.94	113
The Globemasters	Walk to Defeat ALS St. Louis	$82,622.34	32
Ragnar Relay to honor Steve Krohn	2015 ONE DOLLAR DIFFERENCE EVERGREEN CHAPTER	$75,995.00	2

*Note: If you have ever registered as a fundraiser, volunteered, or made an online donation to our chapter, please log in with your username and password before completing this form.

1.

Please enter your contact information below:

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

*

Name:

First Required	Middle Required	Last Required	Suffix

*

Email: Required

Street 1:

Street 2:

City/State/ZIP:

City	State	ZIP

*

Phone Number: Required

Employer:

Gender:

*

Date of Birth: Required

Date of Birth:

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

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

Keep me logged in. What's this?

Please enter a user name and password for logging in when you return. You can use this password to update your information or receive personalized content.

*	User Name: Required	5 to 60 characters
*	Password: Required	12 to 99 characters
*	Repeat Password: Required

*2.

Question - Required - What is the best way for us to contact you?

Email

Phone

Text

Facebook

3.

Question - Not Required - How would you like to help? (you may choose more than one)
Please make between 1 and 3 selections from the choices below.

	Walk Committee Volunteer
	Walk Day Volunteer
	Office Volunteer

*4.

Question - Required - Please select your availability for the day of the event.
Please make between 1 and 3 selections from the choices below.

	Morning (3-4 hours)
	Afternoon (3-4 hours)
	Full Day (about 7 hours)

5.

Question - Not Required - If you are interested in serving on one of our Walk Committees, please indicate your area of interest: (you may choose more than one)

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

*6.

Question - Required - Please select the answer that best describes your relationship to ALS.

*7.

Question - Required - What size t-shirt do you wear?

Adult Small

Adult Medium

Adult Large

Adult XL

Adult 2XL

Adult 3XL

8.

Question - Not Required - Are you interested in creating a fundraising team for this event?

Yes

No

9.

Question - Not Required - Please list any languages you are proficient in, other than English.

10.

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

11.

Question - Not Required - Have previous volunteer experience? Let us know!

Please feel free to reach out to Janelle Webb at jwebb@alsagoldenwest.org with any questions/ concerns.

Inland Empire Walk Volunteer Form

*Note: If you have ever registered as a fundraiser, volunteered, or made an online donation to our chapter, please log in with your username and password before completing this form.

Our Local Sponsors

Inland Empire Walk Volunteer Form

*Note: If you have ever registered as a fundraiser, volunteered, or made an online donation to our chapter, please log in with your username and password before completing this form.

Our Local Presenting Sponsor

Our Local Sponsors