TSC Canada Volunteer Application - TSC Alliance

TSC Canada Volunteer Application

I am submitting this application to serve as follows: (check one)

Provincial Representative

Board of Directors

Personal Information

Name

Name

First

First

Last

Last

Address

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Country

Country

Primary Phone

Secondary Phone

Email

Place of Employment

Position

Special Skills

Please describe:

Community Involvement

Please describe:

Personal or Professional References

Name

Name

First

First

Last

Last

Contact Information

Name

Name

First

First

Last

Last

Contact Information

Name

Name

First

First

Last

Last

Contact Information

Committees of Interest

Check all that apply:

Parent & Family Support

Fund Development/Grant Writing

Governance

Public Relations

Outreach

Science/Medical/Clinic Contact

Please write a brief summary of why you are interested in volunteering with TS Canada ST.

Please explain how you can contribute to the TSCST mission - TS Canada ST is a voluntary, non-profit, charitable organization dedicated to the principles of raising public awareness of tuberous sclerosis complex, encouraging mutual support between individuals with TSC and their families, and promoting research and education.

Please provide qualifications you possess which would enable you to volunteer for TS Canada ST. Include experience, education, etc.

Please add any additional information that you believe would be helpful to the current Board of Directors.

Please upload your resume or curriculum vitae.

Maximum file size: 52.43MB

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