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Are you currently in school?
Your Highest Level of Education Required
Expertise (Knowledge, Skills, Experience)
Expertise (Knowldge, Skills, Experience) Cont.

By signing this form, I acknowledge that I have read and agree to abide by the ethical standards set forth by the Family Refuge Center. I understand that my actions as a Board member may impact the Center's reputation and public image, and I agree to notify the Board immediately if any potential conflict of interest or negative impact arises. I certify that the information provided on this form is true and accurate to the best of my knowledge.

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Family Refuge Center

213 Coleman Drive

Lewisburg, WV 24901

Phone

304-645-6324

Email

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