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The Arc's National Council of Self Advocates:
2019 - 2020 Officer Application
Thank you for applying for to be a NCSA Officer.
Do you need help to complete this form or have questions?
Contact Jenny at Sladen@thearc.org.
About You
1. What is your full name?
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2. What is your email address?
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3. What is your phone number?
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4. Please, select your gender.
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Male
Female
Other
5. Please, select your ethnicity/race. Check all that apply.
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American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Other - Write in:
Other - Write in:
6. Please, select your age range.
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18-24
25-34
35-44
45-54
55-64
65-74
75 or older
7. Where do you live? (City, State)
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8. Which chapter of The Arc do you work with, support, or receive services from?
If you don't have a chapter of The Arc, that's OK. Please just let us know this below.
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