EPIC-Y Application
Full Name of Applicant
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First Name
Last Name
Date of birth
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Month
-
Day
Year
Date
Current Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Contact Number
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Area Code
Phone Number
Please share how you have been impacted by the criminal justice system and why you are interested in volunteering to support criminal justice reform?
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What area or topic of interest within criminal justice reform would you like to support with your volunteer hours?
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How much time would you like to dedicate?
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Fewer than 5 hours a month
5-10 hours a month
10-15 hours a month
15-20 hours a month
What do you hope to gain from this experience?
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How did you learn about the Ladies of Hope Ministries?
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Anything else you would like to share?
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Attach any related materials
Applicant Signature
Clear
Thank you & Submit
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