Healthcare Worker Financial Overview / Needs Assessment Form
Thank you for your interest in joining Kitrinos Healthcare! This is a short form which will help us understand your financial needs so we can offer you the most appropriate stipend when you come and work with us. We want to make sure we support you as best we can while you take time out of your schedule to support us. Please note, you are not obligated to fill out this form in order to apply to join our team, but this may have an impact on what we can offer you.
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Email *
Your full name
Your mobile number
Your volunteering position
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Does your stay with Kitrinos Healthcare depend on whether or not you receive funding from us?
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For how long do you intend to volunteer with us?
For how long will you require funding (ie part or all of your stay)? Please specify.
What is your approximate average household income per year?
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What expenses will you be needing support with while volunteering with us?
Notes/Queries
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