SPSFNWA Alumni Network Interest Form
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Email *
About You
First Name *
Current Last Name *
Last Name you went by as a recipient *
Occupation/Job Title
Place of Employment
Contact Information
Preferred Phone Number *
Preferred Email *
Preferred Mailing Address
 *
City *
State *
Zip Code *
Education
Please indicate your educational background as well as any special knowledge, interests, skills, training, or nontraditional education that you think would be helpful for us to know about you as a volunteer.
School, College, or University you Attended *
Degree(s) and/or certificates earned *
Check all that apply 
Required
Area of Study/Major *
What year did you graduate? *
Other Community Involvement
To connect you with other recipients that might be interested in similar topics or organizations, please list any other community organizations to which you belong. 
Were you a recipient of SPSF in Benton, Carroll, Madison, or Washington County?
 *
Required
What calendar years were you an SPSF recipient? (ex. 2009-2013)
 *
Alumni Network Involvement 
 *
What of the following volunteer opportunities would you be interested in participating in? Check all that apply.
Required
Communication
What is the best way to communicate with you? *
Required
What social media to you use?
What would you like to see the Alumni Network do for current recipients? *
Additional comments that you have for or about the SPSFNWA Alumni Network
By checking this box, I hereby certify that as a condition of my volunteer service, I have read, understand and agree to SPSFNWA ’s confidentiality policy as described in this Agreement: SPSFNWA Confidentiality Statement
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Required
By checking this box, I hereby certify that as a condition of my volunteer service, I have read, understand and agree to SPSFNWA ’s confidentiality policy as described in this Agreement: SPSFNWA Volunteer Conflict of Interest Statement and Disclosure
 *
Required

Exceptions to the above Conflict of Interest Statement and Disclosure form are stated below with a full description of the transactions and of the interest, whether direct or indirect, which I have (or have had during the past year) in the persons or organizations having transactions with the Single Parent Scholarship Fund of Northwest Arkansas. (if none, write "none" below)

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Digital Signature *
Date *
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