UPDATE YOUR INFORMATION

Can Do MS Subscriber Preferences

Please note, required fields are marked with an asterisk *

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1. Primary Email Address (Required.)

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2. First and Last Name (Required.)

First Name

Last Name

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3. Zip Code (Required.)

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4. Address and Phone

Address

City/Town

State/Province

Phone Number

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5. Birth Date

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6. How would you most like to receive additional information regarding our organization?
Please select all that apply.

Phone

Snail Mail

Other (please specify)

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7. What type of news would you like to see from us? Please select all that apply.

Programs (in-person and online)

Events Fundraising

eNews

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8. Please rate our communication level.

Too Often

Just Right

Too Little

Other (please specify)

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9. How did you hear about Can Do Multiple Sclerosis?

Social Media (Facebook, Twitter, etc.)

Can Do MS Email

Can Do MS Website

Postcard or Printed Flyer

National MS Society Website

National MS Society Email

Online Search

Friend, Family Member or Colleague

Other (please specify)

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10. Please select any programs, events you have participated with us in the past? Please select all that apply.

JUMPSTART® Program

TAKE CHARGE™ Program

CAN DO® Program

Webinar

Ask the Can Do Team - Online Q & A

Online Library Articles

Vertical Express

Autumn Benefit

Can Do Day

Third-Party Event/Other (please specify)

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* 1. Primary Email Address (Required.)

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* 2. First and Last Name (Required.)

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* 3. Zip Code (Required.)

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* 4. Address and Phone

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* 5. Birth Date

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* 6. How would you most like to receive additional information regarding our organization? Please select all that apply.

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* 7. What type of news would you like to see from us? Please select all that apply.

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* 8. Please rate our communication level.

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* 9. How did you hear about Can Do Multiple Sclerosis?

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* 10. Please select any programs, events you have participated with us in the past? Please select all that apply.

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* 11. Do you have any other communication requests?

1. Primary Email Address (Required.)

2. First and Last Name (Required.)

3. Zip Code (Required.)

4. Address and Phone

5. Birth Date

6. How would you most like to receive additional information regarding our organization?
Please select all that apply.

7. What type of news would you like to see from us? Please select all that apply.

8. Please rate our communication level.

9. How did you hear about Can Do Multiple Sclerosis?

10. Please select any programs, events you have participated with us in the past? Please select all that apply.

11. Do you have any other communication requests?