MS Focus Outreach Volunteer Entry Form Name _______________________________________________________________________________ Address _____________________________________________________________________________ City ___________________________________ State ________________ Zip ___________________ Day Phone _____________________________ Alternate Phone ____________________________ Email Address _______________________________________________________________________ Requirements include: Willingness to travel locally (expenses reimbursed) Reliable internet access Ability to communicate regularly by email Do you meet these qualifications? Yes q / No q Please check off any of the following areas in which you have skills: q writing q public speaking q fundraising q support group facilitator q social media q political advocacy Other__________________________________________________________ Please attach this form to your entry along with a typed essay (limit of 800 words or fewer). *Handwritten essays will not be considered. Be as creative as you like, but your entry must answer the following questions: Why do you want to be an MS Focus Outreach Volunteer? Why is the MS Focus mission to provide for the critical needs of people with MS important to you? What skills or life experiences make you a good candidate for this volunteer position? What would you like to accomplish in this volunteer position? Give specific example(s). Entries will be accepted through the mail and online. Both must be received or time- stamped by April 15, 2018. (See www.msfocus.org for instructions for submitting your application online.) Selectees will be notified by May 15, 2018. Mail to: MS Focus – Awareness Committee 6520 North Andrews Ave., Fort Lauderdale, FL 33309 Additional applications can be obtained by calling 888-MSFOCUS (673-6287)