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Home
Who We Are
Who We Are
Staff
Board
Young Professionals Board
Junior Board
Financials
News and Publications
Internship Opportunities
What We Do
COVID-19 Relief
What We Do
Client Stories
What You Can Do
What You Can Do
Donate
Monthly Giving
Donate Children’s Items
Volunteer
Young Philanthropists
Other Ways To Get Involved
My Child Needs Help
My Child Needs Help
Client Notice
Events
Contact
Contact
Referrals
Donate
Junior Board Application
Apply to the Junior Board today to be a part of something great!
Date
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
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Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
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Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
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Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
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Guam
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Guinea-Bissau
Guyana
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Hong Kong
Hungary
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Indonesia
Iran
Iraq
Ireland
Israel
Italy
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Japan
Jordan
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Libya
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Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
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Mauritania
Mauritius
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Moldova
Monaco
Mongolia
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Morocco
Mozambique
Myanmar
Namibia
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Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
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Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
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Romania
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Virgin Islands, U.S.
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Country
Home Phone
Cell Phone
*
Email
Date of Birth
*
School
*
Grade for coming year
*
Have you volunteered at Emergency Infant Services before?
*
Other Previous volunteer experience
*
Where, what you did, and for how long. Please include leadership experiences
I want to participate on the Emergency Infant Services Junior Board because:
*
What do you hope to gain from your experience on the Junior Board?
*
References
*
Please include name, phone number and relationship to you.
Signature
*
Please type your full name