Alliance for Lupus Research: Survey - Interest Survey

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ALR TeamRaiser Blueprint 2010

Goal:: $100,000.00
Achieved:: $0.00

0 percent of goal achieved.

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Interest Survey - San Antonio

Question - Not Required - I would like more information about:

	Serving on a Walk Planning Committee
	Soliciting potential Corporate Sponsors
	Reaching out to other families touched by lupus
	Participating as a Team Captain, Walker, or Walk-Day Volunteer

Please enter your contact information.

Name:

Title	First Required	Middle Required	Last Required

Email: Required

Street 1:

Street 2:

City/State/ZIP:

City	State	ZIP

Country:

Phone Number:

Employer:

Occupation:

Gender:

Yes, I would like to receive e-mail from Alliance for Lupus Research

Email Format:

Yes, I would like to receive postal mail from Alliance for Lupus Research

Remember me. What's this?

*3.

Question - Required - What is your lupus connection?

	I have lupus
	A family member has lupus
	A friend's family is touched by lupus
	A co-worker's family is touched by lupus
	I work professionally with those touched by lupus
	I have no lupus connection

How did you hear about the Alliance for Lupus Research?

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Question - Not Required - Additional Comments

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