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Family Resource Center Internship Application

  1. Family Resources Center Internship Application
    P. O. Box 188
    Rocky Mount, VA 24151
    Phone: 540-483-5088
    24 Hour Hotline: 540-483-1234

  2. Are you a U. S. Citizen?*

  3. Do you have a valid Virginia Driver's License?*

  4. Have you ever been convicted of a felony?*

  5. Have you ever been charged with assault and battery?*

  6. Are you a "survivor" of domestic violence?*

  7. Have you ever been homeless?*

  8. Do you speak a foreign language?*

  9. Case Management Choices (you may choose more than one)*

  10. Leave This Blank:

  11. This field is not part of the form submission.