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Mentor University Interest Form
1.
Full Name:
2.
Email Address:
3.
Phone Number:
4.
Zip Code:
5.
Current Occupation:
6.
College Preference:
School of Mentoring and Volunteerism
School of Parenting and Guardianship
School of Youth Serving Professionals
7.
Briefly describe why you are interested in Mentor University:
8.
What are your expectations for the Mentor University course(s)?
9.
Have you completed the Developmental Assets Workshop?
Yes
No
10.
If not, are you willing to complete it as a prerequisite for Mentor University?
Yes
No
11.
How would you prefer to receive information about Mentor University? (Email or Phone)
Email
Phone
No Preference