Oregon Volunteer Interest Form

American Heart Association Oregon Volunteer Interest Form
Thank you for your interest in volunteering for the American Heart Association! We depend on the time and talent of volunteers to help us create a healthier world, free of heart disease and stroke, and we can’t thank you enough for representing our mission out in the community. Please complete this interest form and we will contact you shortly with next steps. Thank you!
First and Last Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Zip Code*
Race/ethnicity (select all that apply)*

Black or African AmericanAmerican Indian or Alaska NativeAsian/Pacific IslanderHispanic or LatinoWhitePrefer not to answer
Are you a heart disease or stroke survivor, family member or caregiver of someone impacted by heart disease, stroke or a risk factor like high blood pressure, diabetes or high cholesterol?*

YesNo
If you answered yes to the last question, can you tell us briefly about your experience with heart disease/stroke/etc?
If you have personal experience with heart disease, do you have an interest in becoming more involved in sharing your story and engaging your network via social media?

YesNo
Do you have a specific passion or interest that relates to cardiovascular health? (i.e., heart attack, stroke, high blood pressure/hypertension, congenital heart disease, maternal health, women’s health, health equity, etc.)
Please check (all that apply to you) volunteer events and activities you would prefer to be involved with at AHA:*

Go Red for WomenHeart & Stroke WalkHard Hats with HeartHealth FairsClinical/blood pressure check eventsAdvocacySchool EngagementCommunications & Social MediaSpeaking at EventsMaking Phone CallsOther
Please elaborate on any skill you checked in the last question.
If you have clinical or medical experience, please let us know the name of your employer and briefly describe your clinical experience.
How did you hear about the American Heart Association? Please include past volunteer involvement with AHA, if any.
Is there anything else we should know about you that would help us connect you to opportunities that are meaningful to you, for example scheduling preferences or virtual only opportunities?
Should be Empty:

American Heart Association Oregon Volunteer Interest Form