List former addresses or places of residence in the last 10 years:
Please complete individual sections below based on your interests in volunteer service
To the best of my knowledge, the above information is true and is submitted voluntarily. This information may be used and disclosed for internal purposes. I realize as a volunteer for the Ecumenical Shelter Network of Lake County, Inc., I am not paid for my service, and am not covered under worker's compensation. I agree to comply with all guidelines, rules, and procedures.
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