Running for Rare Diseases Team: application to become a RARE Community Partner for 2018. Name First Last Please tell us, are you a...* Patient Parent/Family Member Rare Disease Advocate Other Rare Disease or Condition*Age of RARE Community Partner*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Email* Phone*T-Shirt Size*SmallMediumLargeExtra LargeXXLHow did you hear about Running for Rare?*Social MediaNORD EmailA friendOtherIf other, please describe.What are your preferred methods of communication?* In Person Over the Phone Skype/Facetime Email Facebook Messenger Text Messaging RARE Community Partners and their runners will be matched based on their preferences to ensure the best experience for both parties!Preferences for Your Running Partner*(E.G. Male or Female, Single or Family/Kids, English Speaking and/or Spanish/Other, etc.)Runner Location: Do You Have a Preference?*Remote PartnerLocal to Me/the RARE Community PartnerNo PreferenceWhat 3 words would you choose to describe your personality?* Please tell us why you are interested in joining our team?*Please provide at least three full sentences to respond to this question. Have you advocated for rare diseases in the past? If not, are you interested in becoming an active advocate?Please provide at least three full sentences to respond to this question.If you already knew me, you would know that ____________.Fill in the blank to tell us a little more about yourself.Would you be interested in sharing your experience being a RARE Community Partner on our blog?*YesNoVisit http://running4rare.org/ for an idea of the types of blogs that we would be interested in asking you to write for the team.
