Exit this survey National Corntoss Challenge Champion Application Question Title * 1. Full Name: Question Title * 2. Address: Question Title * 3. City, State, Zip: Question Title * 4. Phone Number: Question Title * 5. Email Address: Question Title * 6. I am... An ALS patient. A relative of an ALS patient. A friend of an ALS patient. A relative of a deceased ALS patient. A friend of a deceased ALS patient. A caregiver. Other (please specify) Question Title * 7. Have you attended any Corntoss events? Yes No Question Title * 8. If you answered yes to the previous question, which Corntoss event did you attend and when? Question Title * 9. Have you ever been involved with other events involving ALS TDI? Yes No Question Title * 10. If you answered yes to the previous question, which ALS TDI event(s) have you attended, volunteered, or donated to? Next