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4.4. SR 11-17-2014
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4.4. SR 11-17-2014
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11/13/2014 4:11:38 PM
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11/13/2014 4:10:36 PM
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11/17/2014
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Does your azency require/allow: <br /> 1. APPLICATION: NO <br /> 2. ORIENTATION PRIOR TO STARTING: YES <br /> 3. HEALTH SCREENING: NO <br /> 4. MANTOUX: NO <br /> 5. BACKGROUND CHECK: NO <br /> IF YES, STATION WILL COVER COST: YES/NO FEE: $ N/A <br /> 6. SMOKING: NO <br /> Please complete the followinz and si,-n below: <br /> 1. CURRENT SAFETY DOCUMENTATION ON FILE WITH RSVP: YES <br /> 2. 9 OF VETERANS SERVED ANNUALLY unknown <br /> 3. 9 OF ACTIVE DUTY MILITARY AND MILITARY FAMILIES SERVED ANNNUALLY unknown <br /> 4. ANNUAL STATISTICS: 9,500 (UNIT OF MEASURE IS residents <br /> 5. IS THE FACILITY WHERE RSVP VOLUNTEERS WILL BE SERVING ACCESSIBLE?YES <br /> Please name any barriers to volunteer service: <br /> Select Agency Type Agency Type Documentation Complete? <br /> (Insert Checkmark) or N <br /> Licensed Healthcare Facility <br /> X Government Entity Y <br /> Non-profit/5016 <br /> (Continue to Partner Agreement Signature Page) <br />
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