Gulf Coast Epilepsy Alliance (GCEA)

GCEA VOLUNTEER FORM

Thank you for your support!

* Today's Date:

Are you interested in volunteering for a particular GCEA event? If yes, kindly specify the event name or date.

* First Name

Preferred Name

* Last Name

Gender

Birthday

* Email

* Mobile Phone

Phone

Address

* City

State

* Postal Code

* Emergency Contact

* Emergency Phone

Employer

If applies... What school & district are you currently attending?

* Do you need a letter for your service hours?

Photo

* Any criminal or felony convictions?

What is your availability? (days/hours/length of commitment)

What type of volunteer work do you like to do? (e.g., administration, making phone calls, client services, remote work, event set-up/take-down, event decorating, driving/running errands, etc.)

Tell us more about how you would like to help, please include your credentials, areas of expertise, and skills...

Do you have any limitations with the type of volunteer work you are willing to do?

List the GCEA events you are interested in volunteering for, tell us more...

Additional notes to help us match you:

Thank you for volunteering with GCEA, we will be in touch soon!

THANK YOU FOR YOUR SUPPORT!

Est. 2019, Gulf Coast Epilepsy Alliance (GCEA) is dedicated to providing essential services and support to individuals affected by epilepsy, seizures, and other brain disorders.
Did you know?
1-in-10 will have a seizure in his or her lifetime and 1-in-26 will be diagnosed with epilepsy. [cdc.gov]
Learn Seizure Safety with GCEA!
Through generosity of foundations, corporations and individuals, GCEA is making a real difference in the lives of those touched by epilepsy, seizures and brain disorders across the Coastal Counties of Texas.
GCEA is a 501(c)(3) charitable organization, all contributions are tax deductible. Your generous donation will fund Gulf Coast Epilepsy Alliance's mission.

EIN# 84-2099498