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Step
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Title
*
Haitian Refugees
Social Services
Doctor’s Office
Other
Write Details For Other
*
Name
*
First
Last
Email
*
City
*
Phone
Next
Language
*
English to Haitian Creole
Haitian Creole to English
Is this happening via Zoom or telephone?
*
Zoom
Telephone
Other
Date / Time of Service
Date
Time
Duration
*
1 Hour
2 Hour
Half Day
Full Day
Other
Write Details in Case of "Other" Duration
Type of Assignment
Haitian Refugees
Social Services
Doctor’s Office
Other
Write Details in case of Other
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