American Liver Foundation: Survey - Run for Research Application

Run for Research Application

About You

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Name:

First Required	Middle Required	Last Required

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Email: Required

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Street 1: Required

Street 2:

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City/State/ZIP:

City Required	State Required	ZIP Required

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Country: Required

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Phone Number: Required

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Employer: Required

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Occupation: Required

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Gender: Required

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Date of Birth: Required

Date of Birth:

Month

Day

Year

Email Format:

Remember me. What's this?

Question - Not Required - Do you have a special interest in liver disease? Will you be running in honor or memory of someone?

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Question - Required - Please tell us about your involvement in other charities, civic groups or other organizations. Describe any fundraising experience you have (which charities, how much raised, etc).

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Question - Required - I'm interested in being matched with and running in honor of a patient with a liver disease.

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Question - Required - What is your personal fundraising goal? (Minimum fundraising goal for Official Charity Runners is $3,250; for Qualified Runners or Runners who have obtained an official entry it is $750)

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Question - Required - How do you plan to reach your fundraising target?

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Question - Required - Does your employer match charitable donations?

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Question - Required - How did you hear about RFR?

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Question - Required - What prior run experience do you have? Please include information on number of half and full marathons you have completed.

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Question - Required - In how many prior years have you been a member of the RFR team?

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Question - Required - How did you obtain your 2010 Boston Marathon bib number? (For Qualified Runners only)

Question - Not Required - Please explain in detail where you received your number or at what marathon you qualified. (For Qualified runners only)

Question - Not Required - If we can add more runners to the team, we can raise more money to help people afflicted with liver disease. Do you know any BAA-qualified runners who may be interested in joining Run for Research? Do you know someone who has an invitational entry from another source who might want to train with us? If so, please provide contact information so we can tell them about the team.