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First Name: *  
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Address: *
 
City: *  
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Volunteer Details
Availability: * What days are you available? (check all that apply)
 
Weekday Daytime
Weekday Evenings
Weekend Daytime
Weekend Evenings
 
Interests: * What kind of activities are you interested in? (check all that apply)
 
Fundraising Events e.g. Walk
Patient Programs e.g. KEEP
Office Work/Mailings
 
Experience: * Do you have experience with: (check all that apply)
 
Public Relations
Public Speaking
Marketing
Events
Fundraising
None of the above
 
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