Thank you for your interest in becoming a volunteer advocate with the Campus Sexual and Relationship Violence Center (SRVC). Please complete the following information by August 4th. You will receive a message from the SRVC in response prior to August 10th.

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* 1. Name

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* 2. UARK email address

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* 3. Please check which applies

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* 4. Position Title

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* 5. Department

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* 6. Campus Phone Number

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* 7. After Hours Phone Number

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* 8. Name of Supervisor

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* 9. UARK email of supervisor

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* 10. Why do you want to be a SRVC staff/faculty volunteer advocate?

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* 11. I am able to serve after hours for a week at a time.

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* 12. I am able to attend the required training on August 10th from 8:30-4:30.

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