F-1 Local Coordinator Application
Contact Information
First Name
*
Last Name
*
City
US State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
E-mail
*
Preferred Phone #
*
Format: (000) 000-0000.
Secondary Phone #
Format: (000) 000-0000.
How did you hear about us?
*
Please select....
Internet
Friend
School
Coordinator
Reference
Other.
Basic Information
Gender
Male
Female
Age
*
How many years have you lived in your community?
Are you enthusiastic about working with people in your local community?
*
Yes
No
Do you have experience and or have the ability to work with and oversee teenage youth?
*
Yes
No
You understand this work is based from home and it is not required to work in an office?
*
Yes
No
Do you have good communication skills, timely response and follow up?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
Are you proficient with completing paperwork, ie: computer skills, scanner?
*
Yes
No
You understand this work better serves as supplemental income this is not full-time employment?
*
Yes
No
I certify that I am authorized to work in the United States.
*
I Agree
Anything else you would like to add?
Resume (Optional)
Resume (if available)
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File Size Limit 5MB
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