Volunteer Interest Form
Thanks for your interest in becoming a volunteer with us! We can't wait to get to know you better.
Volunteer roles desired
How would you like to help? Please check all that apply!
Sharing my story publicly
(via social media, speaking, or traditional media)
Advocates Leading Locally in Extraordinary Service = A.L.L.I.E.S.
(start a volunteer team in your own community or join an existing one)
Young Allies
(focus on young-onset issues--variety of roles available)
Buddy
(support someone with a like journey over internet or phone)
Community events
(find local community events and represent us)
Outreach
(to welcome, thank, or encourage participation from other allies by phone or handwritten card)
DIYnamo
(create your own fundraiser based on your passion, start a Dress in Blue Day, online donation page honoring a loved one, Facebook fundraiser)
Undy RunWalk
(event day support or help plan your local Undy RunWalk)
In what ways are you happy to share your story? (Check all that apply.)
In-person speaking with a group
Social media
Video for Alliance website and/or social media
Radio
Print media
Television
If I have an email template or script, I am also comfortable pitching a colorectal cancer story to my local media.
A.L.L.I.E.S. interest (Check all that apply.)
Join a volunteer team, if available in my area
Help start a local volunteer team
Young Allies interest
(Check all that apply.)
Supporting peers
Armchair Advocates--making an impact from home via the internet
Events
Speaker
Fundraiser
In what ways are you open to connecting with a Buddy? (Check all that apply.)
Through the Alliance Facebook community Blue Hope Nation
Through e-mail
Over the phone
What is the farthest you are willing to travel to represent us at a community event?
5-10 miles
11- 25 miles
26-45 miles
Up to 60 miles
DIYnamo interest (Check all that apply.)
Create your own fundraiser
Dress in Blue Day
Blue Star Tribute Page to honor a loved one
Facebook Fundraiser
Undy RunWalk Volunteer
In which Undy RunWalk task are you interested? (Check all that apply.)
Event day volunteer
Undy RunWalk planning committee
Have you participated in an RunWalk?
Please select...
Yes
No
Check all that are true for you.
I can be on my feet for extended periods of time.
I can be outside on a chilly day.
I can be outside on a hot day.
I can be outside on a rainy day.
I can move boxes.
I like a fast-paced task.
I am good at customer service.
I like talking to people.
Committee Interest
Community Partnerships
Event Logistics
Fundrasing
Marketing
Volunteer recruitment and management
Other
RunWalk Location
Please select...
Atlanta
Buffalo, NY
Chicago
Cincinnati
Cleveland
Dallas-Ft. Worth
Denver
Detroit
Jersey Shore
Macon
New York City
Philadelphia
Phoenix
Pittsburgh
Portland
Sacramento
San Diego
St. Louis
Tampa
Washington, DC
Group Involved?
Please select...
Yes
No
Group Name
Group Size
Please select...
1-2
3-5
6-10
11-15
16-20
21+
Salutation
Please select...
Dr.
Miss
Mr.
Mrs.
Ms.
First Name
Last Name
Birthdate
Select from the calendar
Connection to Colorectal Cancer
Patient/ Survivor
Caregiver/ Family Member
Healthcare Professional
Other
In a sentence or two, tell us what made you want to volunteer with the Alliance. (We are so glad you are here, by the way!)
Other
In the future, all volunteers will receive an Alliance T-shirt. Please select your preferred size.
Please select...
XS
S
M
L
XL
2XL
3XL
Your contact info
Email Address
Phone
Mailing Street
Mailing City
Mailing State/Province
Please select...
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Mailing Zip/Postal Code
Would you help us assess the diversity and inclusivity of our community by answering some quick demographic questions?
Sure!
No thanks.
Demographics
Gender
Please select...
Female
Male
Non-binary/third gender
Prefer to self-describe
Prefer not to answer
Race/Ethnicity
Please select...
Asian/Pacific Islander
Black non-Hispanic
Hispanic (of any race)
Multiracial
Native American or American Indian
Other
Unknown
White non-Hispanic
I Prefer Not To Disclose
Age
Please select...
Under 30
31 - 40
41 - 50
51 and over
Prefer not to answer
How did you hear about us?
How did you first hear about the Colorectal Cancer Alliance volunteer program?
Web search (Google, etc.)
The Colorectal Cancer Alliance (our website, social media/Blue Hope Nation, helpline or an email from us)
Written materials in an office
An event
Someone I know
Another organization
How did you first hear about the volunteer program from the Colorectal Cancer Alliance?
From our website
From our social media
From Blue Hope Nation
From our helpline
From an e-mail from us
Which organization?
Which event?
Whom may we thank?
If you have helped the Colorectal Cancer Alliance in the past, tell us how! (Please check all that apply.)
Attended event
Volunteered
Donated
Shared my story
Raised awareness in another way
Availability
When do you have availability to volunteer? (Please check all that apply.)
Weekday mornings
Weekday afternoons
Weekday evenings
Weekends
In a typical week, how many hours can you volunteer?
1
2-5
6-10
11-15
16-20
Do you have regular access to the following? (Check all that apply.)
Computer
E-mail
Internet
Smartphone
Skills and interests
Language(s) Spoken
Skills (check all that apply)
Administrative support
Customer service
Data entry
Event planning
Fundraising
Graphic design
Media
Medicine
Outreach and engagement
Photography
Process improvement
Public speaking
Video editing
Writing and editing
Other
What other skills do you wish to share?
Please share any professional, volunteer, or life experience that will help us know how to best use your skills!
Help us make new allies
Our allies can often help us create strategic partnerships to spread awareness, etc., by making introductions for us. Current employers and an alumnus' connection to a school can really help, as many organizations have health fairs and other ways to connect.
School(s) you attended
Employer
Agreements
I am at least eighteen years of age.
Yes
I understand that volunteers may be photographed and/or submit photographs, video and other media content for educational, archival, and public relations purposes for Colorectal Cancer Alliance.
Yes
I understand that I will receive communication from the Colorectal Cancer Alliance.
Yes
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