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  • Personal Information

  • Availability

  • Confirmation

    I understand that an Interfaith staff member will call the phone number I have listed above to obtain my social security number (necessary for a background check) in order for this application to be processed. I understand that printing my name above is the same as signing a printed copy of this form. By checking the box above and signing this form electronically, I certify the above facts are true and complete to the best of my knowledge. I authorize investigation of all statements and references listed above, and I give consent to verify my criminal history, driving record and the abuse registry, as needed.
  • This field is for validation purposes and should be left unchanged.
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