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Privacy is very important to us. No information sent to Intensive Therapeutics will in any way be distributed or shared without your acknowledgement and consent.
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Intensive Therapeutics Volunteer Form
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| Contact Information |
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Full Name:
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Street Address:
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City:
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State:
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Zipcode:
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Home Phone Number:
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Cell Phone Number Optional:
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Work Number:
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Email Address:
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| Availability |
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Which Programs are you available to Volunteer for?
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Camp Helping Hands
Camp Leaps and Bounds
After School Program
Mini Camp Helping Hands
Saturday Special Needs Programs
Other: |
| Speacial Skills |
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.
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| Previous Volunteer Experience |
| Summarize your previous volunteer experience. |
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| Person to Notify in Case of Emergency |
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Full Name:
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Street Address:
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City
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State
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Zipcode
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Home Phone Number:
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Cell Phone Number Optional:
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Work Phone Number:
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| Background Check |
| Has a recent (within 6 months) background check been completed? |
Yes No |
| If yes, please submit a copy with your completed application. If no, please pursue getting a volunteer background check completed. Each volunteer is responsible for providing their own background check prior to volunteering. Call: 973-771-1582 if assistance is needed. |
| Agreement and Signature |
| By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. |
Agree Disagree |
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Today's Date is:
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1/7/2009
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| Our Policy |
| It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
Thank you for completing this application form and for your interest in volunteering with us.
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