Home Safety Visit Worker Application Form

Individuals interested in completing Home Safety Visits for Host Families or Backup Host Families should complete the following form prior to providing a home safety visit. This application will be reviewed by GWCA/CAN Program Staff, and you will be sent an email approving or rejecting your application. After approval, you will receive GWCA/CAN's Home Safety Visit Form and Contract (as a single document) which you must complete and return to GWCA/CAN within one week of approval. The form will contain directions on how to submit the HSV Form and Contract to GWCA/CAN.
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