Current Results for Susan G. Komen Houston Volunteer Application
1. Date
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Latest User Responses: |
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01/15/2021
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12/31/2020
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11/23/2020
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11/12/2020
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10/16/2020
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View All Responses for question #1
2. Your information:
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3. I prefer to be contacted by:
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4. Name:
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Latest User Responses: |
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Alicia Rodriguez
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Tommie Morgan
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Kishawn Joseph
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Charles Tangu
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bruce nguyen
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View All Responses for question #4
5. Phone:
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Latest User Responses: |
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7133774754
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713-303-1762
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832-642-4373
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8325677594
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281-691-4445
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View All Responses for question #5
6. Relationship to Volunteer:
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Latest User Responses: |
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Mother
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Spouse
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Daug
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Father
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husband
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View All Responses for question #6
7. What is your experience with breast cancer?
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8. Have you volunteered in the past for the Susan G. Komen Houston, another Komen Affiliate or Komen Headquarters?
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9. If so, how?
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Latest User Responses: |
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User Provided No Response
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User Provided No Response
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Stuffing swag bags
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Race, Volunteer Educator, Facilitator,
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User Provided No Response
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View All Responses for question #9
10. Why do you want to volunteer for Susan G. Komen Houston?
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Latest User Responses: |
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I want to volunteer for m...
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I am a retired RN Healthc...
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To give back to the commu...
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Susan G Komen fights day ...
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I want to give back to th...
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View All Responses for question #10
11. How often would you like to volunteer?
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12. Availability to Volunteer
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Total Number of Responses 31 |
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13. Please indicate if you have more than one year of experience in the following areas: (You may select multiple areas)
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Total Number of Responses 31 |
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14. If you speak a foreign language and are willing to share your skills, please indicate which language(s)
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Latest User Responses: |
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Spanish
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User Provided No Response
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User Provided No Response
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N/A
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vietnamese
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View All Responses for question #14
15. Please list any additional skills that you would be willing to contribute as a volunteer.
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Latest User Responses: |
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- Knowledge of Social Media
- Customer Service
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User Provided No Response
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User Provided No Response
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User Provided No Response
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User Provided No Response
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View All Responses for question #15
16. Have you ever been convicted (including entering a plea of guilty or nolo contendere) of any felony crimes with in the past 7 years? Do not include convictions that were sealed or expunged pursuant to a court order.
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17. Have you been charged with any crime involving a child?
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18. If you answered "Yes", please provide the following information: The date, place of the offense and charge.
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Latest User Responses: |
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User Provided No Response...
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User Provided No Response...
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User Provided No Response...
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User Provided No Response...
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User Provided No Response...
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View All Responses for question #18
19. What other information do you believe is pertinent to our full understanding of this matter?
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Latest User Responses: |
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User Provided No Response
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I was forced to retire early due to an illness from which I have recovered. I don't want to go back to a job, but really miss contact with patients and family members
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User Provided No Response
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User Provided No Response
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User Provided No Response
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View All Responses for question #19
20. Volunteer Signature:
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Latest User Responses: |
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Heidi Parra
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Craig K Morgan
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Lashawn Johnson
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Keumboh Tangu
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thuy chau
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View All Responses for question #20
21. Parent's or Guardian's Signature: (If volunteer is under age 18)
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Latest User Responses: |
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User Provided No Response
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User Provided No Response
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User Provided No Response
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User Provided No Response
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User Provided No Response
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