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* 1. Which area would you like to support?

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* 2. What is your first name?

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* 3. What is your last name?

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* 4. Date Of Birth

Date

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* 5. Address

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* 6. Do you have any children under 18?

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* 7. Which race/ethnicity best describes you? (Please choose only one.)

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* 8. What type of mobile telephone do you PRIMARILY use?

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* 9. What language do you mainly speak at home?

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* 10. Have you ever served in any branch of the United States military, or not?

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* 11. Why would you like to volunteer with United And Guided? (Check all that apply).

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* 12. Which are your preferred forms of social media?

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* 13. Please check your hours of availability? (Click all that apply.)

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* 14. Who referred you to this volunteer opportunity?

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