Volunteer Registration

SIGN UP TO BE A PART OF TEAM NMF

Now that you have learned all about The National Marfan Foundation and how you can make a difference in the lives of those affected with Marfan syndrome and related disorders, take the next step and join our team.

Please complete the following registration and you will be an official member of Team NMF!

Question Title

* 1. Please enter the following contact information

First Name

Last Name

Address 1

Address 2

City

State

Zip Code

Home Phone

Cell Phone

Email address

Question Title

* 2. Gender

Female

Male

Question Title

* 3. Highest level of Education

High School Diploma or GED

Some College

Bachelors Degree

Graduate degree

Other (please specify)

Question Title

* 4. Ethnicity

White

Black or African-American

Hispanic/Latino/Spanish

Asian

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Other (please specify)

Question Title

* 5. Date of Birth

Enter your Date of Birth

Date

Question Title

* 6. Enter your occupation or company for potential corporate opportunity (contact) & matching gift

Question Title

* 7. How did you hear about the NMF?

Friend

Family member

Doctor

NMF website

Other website

Received a mailing

Other (please specify)

Question Title

* 8. Have you attended an NMF event or local group meeting(s) ?

Yes

Question Title

* 9. If you answered "Yes" to question # 8, please describe any events or meetings you've attended (ie. annual conference,Chapter or Network Group meetings).

Question Title

* 10. Do you receive the NMF newsletter, Connective Issues?

Yes, I receive it by mail

Yes, I receive it on-line

No, I do not receive the newsletter

Question Title

* 11. Have you volunteered for any other organizations? If so, please describe.

Question Title

* 12. What are your hobbies and interests?

Question Title

* 13. Additional comments or skills you would like us to know to place you in a volunteer position

Question Title

* 14. I am available to volunteer

Weekly

Monthly

Occasionally

Question Title

* 15. I am interested in the following volunteer positions

Network Group Chair

Support Group Leader

Community Support Volunteer

Awareness Volunteer

Fundraising Volunteer

Advocacy Volunteer

Question Title

* 16. Emergency Contact Information

Emergency Contact Name

Emergency Contact Phone

Relationship to Volunteer

TEAM NMF RELEASE

I wish to volunteer for the NATIONAL MARFAN FOUNDATION, Team NMF.
I understand that the nature of volunteer activities that I may perform in my capacity as a volunteer may involve physical activity, contact with unidentified or unfamiliar persons, or other potential risk of bodily injury or damage to property and I hereby voluntarily assume full and complete responsibility for, and the risk of, any injury or accident which may occur during my volunteer work with the NATIONAL MARFAN FOUNDATION. To the fullest extent of the law, I, for myself, my next of kin, my heirs, administrators, and executors (collectively, “releasors”), hereby release and hold harmless and covenant not to file suit against (i) the NATIONAL MARFAN FOUNDATION, their respective directors, officers, volunteers, patients, agents and employees; and (ii) all other persons or entities associated with the NATIONAL MARFAN FOUNDATION (collectively, the “releasees”) for any injury or damages I might suffer in connection with my volunteer work with the NATIONAL MARFAN FOUNDATION. This release applies to any and all loss, liability, or claims I or my releasors may have arising out of my volunteer work with the NATIONAL MARFAN FOUNDATION, including but not limited to, personal injury or damage suffered by me or others, whether such losses, liabilities, or claims be caused by contact with and/or the actions of other persons, contact with fixed or non-fixed objects, negligence of the releasees, risks not known to me or not reasonably foreseeable at this time, or otherwise.
I understand that as a volunteer, I may become privy to confidential information about a Releasee. I agree to maintain the confidentiality of any information marked “confidential” as well as any information about each Releasee’s business operations, organizational structure, employee information, patient information, financial operations, marketing strategy, organization, donor lists and amounts, plans for upcoming events, current or proposed business transactions and sponsorships, and any proprietary information such as computer software and programming and the like that is not otherwise publicly disclosed. I will not use any confidential information in any manner that would be detrimental to a Releasee.

At all times during my volunteer work with the NATIONAL MARFAN FOUNDATION, I will conduct myself in such a manner as not to reflect unfavorably on or in any way diminish the reputation of the NATIONAL MARFAN FOUNDATION.
I give my consent and permission to the NATIONAL MARFAN FOUNDATION, successors, licensees, and assigns the irrevocable right to use, for any purpose whatsoever and without compensation, any photographs, videotapes, audiotapes, or other recordings of me that are made during the course of volunteering with the NATIONAL MARFAN FOUNDATION.

This Release shall be construed under the laws of the state in which the NATIONAL MARFAN FOUNDATION is located. In the event any provision of this Release is deemed unenforceable by law, (i) the NATIONAL MARFAN FOUNDATION shall have the right to modify such provision to the extent necessary to be deemed enforceable; and (ii) all other provisions of this Release shall remain in full force and effect.

I understand that I have given up substantial rights by signing this Release, and have signed it freely and voluntarily without any inducement, assurance or guarantee being made to me and intend my signature to be a complete and unconditional release of liability to the greatest extent allowed by law.

Information to Team NMF Applicants

You may be asked to sign an authorization for the NATIONAL MARFAN FOUNDATION to fully investigate your suitability for volunteering (depending on the position and responsibilities) by obtaining information from your previous employers and/or other knowledgeable persons as to their firsthand experiences with you, and also, when deemed necessary, by obtaining reports from credit bureaus, credit agencies, or other consumer reporting agencies. Under some circumstances, certain of such reports may be “consumer reports” or "investigative consumer reports" as to which, under the Fair Credit Reporting Act, you are entitled, upon your request in writing, to receive a complete and accurate disclosure of the nature and scope of the investigation requested by National Marfan Foundation.

Volunteer Applicant Statement

I certify that I completed this volunteer application and that all the answers to the questions on this volunteer application and any attachments are to the best of my knowledge true and correct and that I have not knowingly withheld any pertinent facts or circumstances all of which are subject to validation. I understand that any misrepresentation, false statement, or omission made by me with respect to the information contained in this volunteer application could disqualify me from consideration as a volunteer, or if selected as volunteer, result in the termination of my volunteer efforts from the National Marfan Foundation.

If selected as a volunteer, I agree to comply with the rules and regulations of The National Marfan Foundation.

Question Title

* 17. I agree to the release as stated above

I agree

I do not agree