I AM ALS In Memoriam Video 2024 Question Title * 1. What is your email address? Question Title * 2. What is your loved one's first and last name? Question Title * 3. What is your loved one's birth year? Question Title * 4. I give consent for I AM ALS to use my loved one's name, birth year, and/or photos. Yes No Other (please specify) Question Title * 5. My loved one passed in 2024. Yes No Question Title * 6. Upload a picture of your loved one. Question Title * 7. Upload a picture of your loved one. Question Title * 8. Upload a picture of your loved one. Question Title * 9. Do you want to subscribe to I AM ALS' newsletter? Yes No You're almost done! Click "Done" to be redirected to the required consent form. Done
