Step 1 of 3 33% Volunteer Update RequestTHIS FORM IS ONLY FOR UPDATING YOUR VOLUNTEER INFO IF YOU SIGNED UP AFTER APRIL 2020. Thank you for updating your contact info below!! Edits will be made within a few days. Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Suffix Preferred Name Title (RN, MD, Psychologist, etc.) Primary Email Address Alternate Email Address Would you like to be listed on our Volunteer Network which is our online database where your name, email and region are available for moms?*Yes, please!No, not at this time.No, but I'd like to help in other ways.No, but you may update me on HG events/news.I consent to my contact information being available to those requesting support:*Yes, you may include my email address.Yes, you may include my phone number.Yes, you may include my phone number and email.No, I'd rather not.Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Area/Region (e.g. Chicago area, North Austin)Primary PhoneIs Primary PhoneLandlineMobileAlternative PhoneSelect Your Age Rangeunder 2525-3535-45over 45Year of First PregnancyGenderFemaleMaleLanguages you speak How many hours do you feel you can commit each week? What activities do you prefer and feel suit your experience & training best?What activities do you prefer and feel suit your experience & training best? Grant writing Talking to media Visiting HG moms Supporting research Computer/IT Support Recruiting for research Writing blogs & articles Supporting moms online Podcasting/digital media Sending cards to HG moms Writing policies & procedures Using social media for outreach Speaking at conferences & events: Fundraising Events & Networking Helping with events & conferences Developing brochures & infographics Printing & distributing HG brochures Reviewing other webpages about HG & HER I'm a health professional, scientist or researcher Anything at all Other Translating - Language Can you clarify on your selection of Other?Can you share which languages you can assist with for translating? What special skills or training do you have that you would like to use? Tell us briefly about your experience with HG.Get InvolvedWould you like to share your feedback and ideas for supporting mothers with HG?*Yes, I'd love to.No, not at this time.In what ways can we reach more HG moms & others interested in HG?How do you think we could reach and get more women engaged in our cause?What are some of the most common questions you are asked or that may need more attention in our educational efforts?What would you say are the most important things a new volunteer or support person should know?What are the tips you give most often to moms struggling with HG?Any suggestions for the future of our outreach and education efforts?What is your T-Shirt Size?Adult Extra SmallAdult SmallAdult MediumAdult LargeAdult Extra LargeAdult XXL Δ
