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Madrina application 2022-2023
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Name
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Email
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Address
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Phone
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Occupation
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Languages
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English
Spanish
Other (answer below)
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Other language
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List two personal references (Name & phone)
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Please briefly describe your community involvement.
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Why are you interested in being a Madrina?
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Have you ever been accused or convicted of a crime?
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Yes
No
If yes, please explain and give dates.
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