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SLI APPLICATION
SERVANT LEADER
INTERN APPLICATION
First Name
Middle Name
Last Name
Date of Birth
Age
Home Street Address
Unit #
City
State
Zip code
Home
Cell Phone
Permanent Phone Number
Permanent Street Address (If different from above)
City
State
Zip code
Email
Alternate Email Address
Race/Ethnicity (check all that apply)
American Indian or Alaska Native
Native Hawaiian or Pacific Islander
Asian
Black or African-American
Hispanic/ Latino
White
Other
Gender Identity:
Female
Male
Non-Binary
Decline to state
Other
Preferred pronouns:
She/Her
He/Him
They/Them
Decline to state
Other
How did you find out about this service opportunity?
Are you a Returning Servant Leader Intern?
Yes
No
Were you enrolled in the CDF Freedom Schools Program as a student?
Yes
No
Do you currently live or have you ever lived in the community where this CDF Freedom Schools site is located?
Yes
No
If yes, how many summers have you served as a Servant Leader Intern in the CDF Freedom Schools program?
If yes, how many years did you attend CDF Schools Program as a student? Freedom Schools?
Are you a registered voter?
Yes
No
Sponsor Organization
Site Name
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