ALS Ice Bucket Challenge Progress
  • Sign up
  • |
  • Login
  • |
  • Find local services
  • |
  • |

 

Share Your Story - An ALS Awareness Project

 
 
 

 

Sharing our experiences with ALS is a critical part of raising awareness about this devastating disease.

 

Everyone can help, whether you're a person living with ALS, family member, friend, or concerned individual. In doing so, you are making a difference to the ALS community as we work together to raise awareness and funding to fuel the search for effective treatments and cures for ALS.

 

Please take a moment and fill out the questions below.  You may want to draft your comments separately before entering them below.  If you have any questions, please contact us!

*1.
Question - Required - What is your connection to ALS?









*2.

*3.  


*4.

*5.

*6.

*7.

*8.


9. Please enter some information about yourself in the fields below: (For proper photo credit and release of information)

*

Name:

 

 

 

 

 

         

*

*

 

*

City/State/ZIP:

 

    

 

 

 

If you respond and have not already registered, you will receive periodic updates and communications from The ALS Association.

 

What's this?

 

Thank you for sharing your ALS story!

   Please leave this field empty