Gulf Coast Epilepsy Alliance

GCEA VOLUNTEER FORM

Thank you for your support!

* Date:

* First Name

Preferred Name

* Last Name

Gender

Birthday

* Email

* Mobile Phone

Phone

Address

* City

State

* Postal Code

* Emergency Contact

* Emergency Phone

Employer

Or, 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?

Is there a GCEA event 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!

Est. 2019

Gulf Coast Epilepsy Alliance (GCEA) is a 501(c)(3) nonprofit organization dedicated to providing essential services and support to individuals affected by epilepsy, seizures, and other brain disorders in the Gulf Coast region of Texas.

Gulf Coast Epilepsy Alliance

GCEA VOLUNTEER FORM

Thank you for your support!

Est. 2019

Gulf Coast Epilepsy Alliance (GCEA) is a 501(c)(3) nonprofit organization dedicated to providing essential services and support to individuals affected by epilepsy, seizures, and other brain disorders in the Gulf Coast region of Texas.

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]