Common Contracts
1 similar null contracts
FOR OFFICE USE ONLYApril 5th, 2021
Name: Agency Name: (This information may be published on the CVSSD/ACP Website, only use public address) Agency Mailing Address: City: Zip Code: County: Advocate Email: Advocate Phone: Supervisor Name: Agency Phone: Do you provide direct services to victims of DV, SA, stalking and/or human trafficking (select one)?YES NO Do you provide comprehensive safety planning to victims of DV, SA, stalking and/or human trafficking (select one)?YES NO Date and name of agency where you completed a minimum of 40 hours in person DV/SA advocacy training:Date (mm/yy): Agency: Date you took the DOJ online training: (Please remember to attach your certificate)Date (mm/yy): Languages other than English:
