Thank you for expressing your interest in becoming a Polaron Connect Community Connector. We will review your answers and get back to you regarding the next steps as soon as possible.

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* 1. First Name

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* 2. Last Name

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* 3. Organisation you are part of (if applicable)

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* 4. Phone number

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* 5. Email address

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* 6. State of Residence

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* 7. Town of Residence

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* 8. Briefly describe your previous experience as a bi-lingual worker

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* 9. What is the background of the people you can reach out to? (Please specify their backgrounds, for example, Afghan, Congolese, Syrian.)

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* 10. Are you able to attend training sessions and provide updates on your efforts and results?

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* 11. What languages do you speak?

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* 12. Would you be willing to travel within your state if needed?

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* 13. Do you have a current police check?

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* 14. Is there anything else you’d like us to know about your skills or availability?

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