You & LCN Fundraising
The purpose of this survey is to invite you to help us raise funds for the LCN.
About You
If you would like to learn more about the LCN and how you can help raise funds, please provide us with information about you.
First Name *
Your answer
Last Name *
Your answer
City and State where you live *
Your answer
Email *
Your answer
Phone Number *
Your answer
What Leukodystrophy has affected your family? *
Your answer
How are you related to the affected individual? *
Your answer
Do you have a family member or friend who wants to help? *
Please let us know what experience and/or ideas you have for raising funds for the LCN. *
Your answer
Any other comments and/or questions?
Your answer
Thank You!
Thank you so much for completing this survey. We hope to get back to you soon.
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