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Current Results for PAX What A Difference A Day Makes Volunteer Application
1. About you:
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2. Please provide your cell # with Area Code
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Latest User Responses: |
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I am inquiring about volunteering for day to help someone with MS. If possible, I would like to take my 15 year old daughter to help also. My phone number is 724-713-2913. Thank you.
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(507) 702-2027
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814-577-4533
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412-337-6758
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7174680177
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View All Responses for question #2
3. Interests/Skills in Gardening:
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4. Interests/Skills in Painting:
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5. Interests/Skills in Carpentry:
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6. Interests/Skills in Plumbing:
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7. Interests/Skills in Small Electrical Repair/Installation:
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8. Do you speak a second language?
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View All Responses for question #8
9. Are you medically trained as a doctor, nurse, EMT or other?
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10. Would you like to be on our Handyman Team and be available to help with small home repairs for people with MS in our Chapter?
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11. Our chapter services 56 counties in Central and Western Pennsylvania. Please list all the counties that you would be interested in serving:
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Latest User Responses: |
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Beaver, Butler and Allegheny
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Keystone chapter
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Clearfield, Centre, Blair
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Allegheny, Washington, Beaver, Butler,
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Central Pa Counties
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View All Responses for question #11
12. We will try our best to match your interests with the services needed. Please check the volunteer assignment that would be your 1st choice.
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13. We will try our best to match your interests with the services needed. Please check the volunteer assignment that would be your 2nd choice.
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14. We will try our best to match your interests with the services needed. Please check the volunteer assignment that would be your 3rd choice.
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15. Please let us know if there is a service above you could not assist with:
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Latest User Responses: |
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survey/responses/919/584919.txt
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View All Responses for question #15
16. Do you have any Food or Pet Allergies? If yes, please explain:
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Latest User Responses: |
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survey/responses/750/605750.txt
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survey/responses/103/685103.txt
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survey/responses/431/705431.txt
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View All Responses for question #16
17. Please provide an Emergency Contact: Name/Relation/and phone with area code.
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Latest User Responses: |
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survey/responses/807/1019807.txt
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View All Responses for question #17
18. Please provide an Emergency Contact #2: Name/Relation/and phone with area code.
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Latest User Responses: |
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survey/responses/950/604950.txt
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View All Responses for question #18
19. I understand and agree to the following conditions. Pictures will be taken and may be used by the Chapter
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20. I understand that the NMSS will do background checks on me. (depending on the outcome of the background check this volunteer position may not be available to you)
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