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Current Results for Mid America Chapter Volunteer Form

1. Please fill in selected fields:

Total Number of Responses

207

2. Emergency Contact with Phone Number and Relation:

Latest User Responses:

Deborah Mc Indoo 816 875-8495
 

 

 

Chris Chapman 320-262-0302 Fiance
 

 

 

User Provided No Response
 

 

 

Byron Pendleton 8168131111 husband
 

 

 

User Provided No Response
 

 

 


View All Responses for question #2

3. Please advise any medical/allergy information:

Latest User Responses:

User Provided No Response
 

 

 

User Provided No Response
 

 

 

User Provided No Response
 

 

 

User Provided No Response
 

 

 

User Provided No Response
 

 

 


View All Responses for question #3

4. Please tell us your connection to multiple sclerosis:

Total Number of Responses 207

Value

 

Count

 

Percent

No Relation

 

83

 

40.1

I have MS

 

35

 

16.9

I am a Friend/Co-Worker of a Person with MS

 

33

 

15.9

Relative: Other

 

26

 

12.6

Relative: Child of a Person with MS

 

13

 

6.3

Relative: Spouse of a Person with MS

 

9

 

4.3

User Provided No Response

 

6

 

2.9

Relative: Sibling of a Person with MS

 

5

 

2.4

Relative: Parent of a Person with MS

 

5

 

2.4

  

5. Please indicate which of the following activities you are interested in:

Total Number of Responses 207

Value

 

Count

 

Percent

Bike MS

 

103

 

49.8

Walk MS

 

78

 

37.7

Other Special Events/DIY

 

60

 

29.0

Programs and Services

 

44

 

21.3

Administrative/Office

 

44

 

21.3

Volunteer Coordinating

 

39

 

18.8

Health Fair

 

39

 

18.8

Youth Programs

 

35

 

16.9

Data Entry

 

35

 

16.9

Exercise/Recreation

 

33

 

15.9

User Provided No Response

 

33

 

15.9

Wellness

 

32

 

15.5

Marketing

 

30

 

14.5

Advocacy/Action Alert

 

29

 

14.0

Peer Support/ Friendly Visitor

 

29

 

14.0

On the Move Luncheon

 

28

 

13.5

Research Advocate

 

25

 

12.1

Photography

 

25

 

12.1

Public Speaking/ Speaker's Bureau

 

23

 

11.1

Contact Sponsors/Corporate Development

 

20

 

9.7

Phoning

 

20

 

9.7

Self Help Group

 

19

 

9.2

Internships

 

14

 

6.8

Truck Driving

 

5

 

2.4

  

6. I have the following skills/experience that I am willing to utilize:

Total Number of Responses 207

Value

 

Count

 

Percent

User Provided No Response

 

61

 

29.5

HAM/Radio Communication Certification

 

42

 

20.3

Data Entry

 

40

 

19.3

Clerical Work

 

35

 

16.9

Internet/Web (Social Networking)

 

35

 

16.9

Event Planning/ Coordination

 

31

 

15.0

Writing

 

29

 

14.0

Public Speaking

 

25

 

12.1

Receptionist

 

25

 

12.1

Volunteer Coordination

 

24

 

11.6

Peer Support

 

22

 

10.6

Emergency Medical/First Aid

 

22

 

10.6

Marketing/Public Relations

 

20

 

9.7

Arts/Entertainment/Music

 

20

 

9.7

Phone/Telerecruiting

 

19

 

9.2

Food Service/Catering

 

18

 

8.7

Photography/Video

 

16

 

7.7

Support Group

 

15

 

7.2

Accounting/Finance

 

14

 

6.8

Database Management

 

10

 

4.8

Counseling

 

9

 

4.3

Exercise Instruction

 

9

 

4.3

Nutrition

 

9

 

4.3

Audio/Visual

 

8

 

3.9

Group Facilitation

 

7

 

3.4

MS Research

 

7

 

3.4

Graphic Design

 

7

 

3.4

Construction

 

7

 

3.4

Employment/Career Counseling

 

6

 

2.9

Media/Journalism

 

5

 

2.4

Publishing/Printing

 

5

 

2.4

Truck Driving

 

4

 

1.9

Banking/Trusts

 

4

 

1.9

Aquatics Instruction

 

4

 

1.9

Social Work

 

3

 

1.4

Grant Writing

 

3

 

1.4

Recreational Therapy

 

2

 

1.0

Government Advocacy

 

2

 

1.0

Physical Therapy

 

2

 

1.0

Physician Other

 

1

 

0.5

Speech Therapy

 

1

 

0.5

Occupational Therapy

 

1

 

0.5

  

7. I have the following certifications/licensing that I am willing to utilize:

Total Number of Responses 207

Value

 

Count

 

Percent

User Provided No Response

 

162

 

78.3

CPR

 

30

 

14.5

First Aid

 

22

 

10.6

EMT

 

6

 

2.9

Registered Nurse

 

6

 

2.9

Wellness Instructor

 

4

 

1.9

Other (CDL)

 

4

 

1.9

Law Degree/Juris Doctorate

 

4

 

1.9

Notary Public

 

2

 

1.0

  

8. Is there anything else you'd like to tell us? Let us know below.

Latest User Responses:

User Provided No Response
 

 

 

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View All Responses for question #8

9. I have read and I understand the Emergency Medical Treatment Authorization, Media Release and Right of Refusal/Dismissal. I agree to follow the Code of Conduct and Alcohol & Drug Use Policy outlined above. Enter your initials in the box below to agree:

Latest User Responses:

PDM
 

 

 

KB
 

 

 

TR
 

 

 

Kate Pendleton
 

 

 

DF
 

 

 


View All Responses for question #9