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Alachua County Crisis Center
218 S.E. 24th Street
Gainesville, FL 32641
Volunteer Application
(Confidential)
Page 1 of 4
Name:
Your name is required!
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Mailing Address: (street, city, state):
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Mailing address is required!
Zip Code:
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Zip code is required!
Home Phone:
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Work Phone:
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Cell Phone:
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E-Mail:
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When and where is the best time to reach you?
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Date of Application:
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Social Security Number:
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Do you plan to live in the Alachua County area for the next year?
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Do we have your permission to do a criminal background check?
Yes
No
Please answer "Yes" or "No".
EDUCATION AND OCCUPATION
Select the highest grade you have completed:
7
8
9
10
11
12
College:
1
2
3
4
5
6
What was/is your major?
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List any college(s) or university(s) you have attended, degree(s) received, and year(s) you received each:
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Please describe other types of positions you have held in the past:
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Current occupation:
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Place of employment:
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Please list 2 personal references
(excluding family):
Reference #1
Name:
Relationship:
Phone #:
Reference #2
Name:
Relationship:
Phone #:
How did you learn about the Crisis Center?
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