Men Stopping Violence

Help us End Violence against Women ... Make a Donation

Quotation from Christi Ketcham, Project South: You are awesome! On behalf of the Youth Council and Project South, we appreciate and thank you for attending and talking to our youth. You are definitely an ally to young people in Atlanta.

Please fill in this questionnaire to the best of your ability according to your interest and skills. We will utilize this information to determine the best placement for your work experience here at MSV. Items with an asterisk (*) are required.

* First Name

* Last Name

* Address line 1

* City

Address line 2

* State

* Zip code

* email address
(We promise not to give your email address to anyone else!)

*Phone number

Home Work Mobile

Alternate phone number

Home Work Mobile

List any schools you attend or other affiliations, including organizations requiring community service or internships.

How did you find out about Men Stopping Violence?

What type of work are you interested in?

When are you available to start?

* Indicate which days of the week and what times you will be available.

Day	Times Available
Monday		Not available
Tuesday		Not available
Wednesday		Not available
Thursday		Not available
Friday		Not available
Saturday		Not available
Sunday		Not available

Please check all skills that pertain to you

Word Processing
Fax Machines
Mail Merging
Copy Machines
Filing
Phones
Secretarial Skills

Computer Technology
Accounting
Carpentry
Electronics
Wiring
Other

Anything else you'd like us to know?

© 2004, Men Stopping Violence
533 W. Howard Ave., Decatur, GA 30030
P: (404)270-9894 F: (404)270-9895
Toll-free: 1- 866-717-9317
msv@menstoppingviolence.org

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