Alzheimer's Association, NYC Chapter - Volunteer Survey

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. The mission of the Alzheimer’s Association is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through brain health. Our vision is a world without Alzheimer’s. To learn more, visit alz.org/nyc or call 800.272.3900, anytime.

Thank you for your interest in volunteering with the Alzheimer's Association, NYC Chapter. Please note that we are not accepting applications for Public Education and Disease Awareness Program Assistance, Support Group Facilitators, and Office Support at this time. We encourage you to complete the survey so that we can contact you when we begin accepting applications at a later date. Inquiries for those interested in Advocacy & Public Policy, and The Longest Day, will be shared with the appropriate chapter staff member as they are received.

* 1. What is your first name?

* 2. What is your last name?

* 3. In what ZIP code is your home located? (enter 5-digit ZIP code)

* 4. At what email address can we reach you?

* 5. At what phone number can we reach you?

* 6. How did you hear about us?

* 7. Why are you interested in volunteering with the Alzheimer’s Association?

* 8. What experiences have you had that may prepare you to work as a volunteer in the field of Alzheimer's disease?

* 9. What type of activities are of interest to you? Please rank in order of preference (1 = very interested; 5 = not interested at all)

* 10. Would volunteering or being placed at the Association fulfill part of an academic or degree requirement?

* 11. What is the highest level of school you have completed or the highest degree you have received?

* 12. What is your degree / major?

* 13. Are you fluent in any of the following languages? (Check all that apply)

* 14. Please indicate the hours you would be able to volunteer

  Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Morning
Afternoon
Evening

* 15. What is your desired start date?

Date / Time

T