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MNM Community Outreach Volunteer Application

1. Please enter your personal information.

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?

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Question - Required - What community outreach activities interest you? (Check all that apply.)

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Question - Not Required - How often would you like to volunteer?

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Confidentiality policy
Registrants of the National Multiple Sclerosis Society, Upper Midwest Chapter have a right to know that all personal records, documents and conversations shall remain confidential. No information that might individually identify a registrant with multiple sclerosis will be released by any staff member or volunteer of the National Multiple Sclerosis Society, Upper Midwest Chapter to anyone outside the agency without the registrant's expressed permission. 

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