Below is a sample of the emails you can expect to receive when signed up to ALS Therapy Development Institute.
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Data Name | Data Type | Options |
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Username | Text Box | |
Password | Text Box | |
Password (confirm) | Text Box | |
First name | Text Box | |
Last name | Text Box | |
Email address | Text Box | |
Confirm email address | Text Box | |
Phone | Text Box | |
Addresss | Text Box | |
City | Text Box | |
Zipcode | Text Box | |
I am (relation to ALS) | Dropdown | Know about ALS |
State | Dropdown | CA |
Country | Dropdown | United Kingdom |
CHOOSE YOUR EMAIL PREFERENCES | Checklist | Monthly Newsletter (PeriodicALS) |
REGISTER
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