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I understand that any falsification misrepresentation or omission of facts called for herein will result in my disqualification from further consideration as a volunteer. Other Names used by applicant if any Date of Birth Place of Birth City/State Drivers License Number Issuing State Expiration Date All funds needed to run Mobile Hope are raised by supporters for the work being done. I may revoke this request at any time but that revocation must be in writing and give 30 days notice of the...
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