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Marysville Crime Prevention Volunteer Application
Name
*
Address1
*
Address2
*
City
*
State
*
Zip
*
Home phone
*
Cell phone
*
Email address
*
Date of birth
*
Emergency contact person
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Emergency contact phone number
*
Level of education
*
High School
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Field of study
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Previous occupation(s)
*
Interests or hobbies
*
Describe other volunteer work you've done
*
Have you ever been convicted of a felony?
*
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No
If you answered yes, please explain
How many hours a week are you available?
*
Who or what prompted you to volunteer?
Reference #1
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Reference #2
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E-signature
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My typing my name, I authorize the Marysville Police Department to do a background check of my driving record and my criminal record
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Today's date
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