* 1. Full Name:

* 2. Address:

* 3. City, State, Zip:

* 4. Phone Number:

* 5. Email Address:

* 6. I am...

* 7. Have you attended any Corntoss events?

* 8. If you answered yes to the previous question, which Corntoss event did you attend and when?

* 9. Have you ever been involved with other events involving ALS TDI?

* 10. If you answered yes to the previous question, which ALS TDI event(s) have you attended, volunteered, or donated to?

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