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* 1. Contact Information

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* 2. Please summarize your leadership positions. Title(s) and dates are all we need.

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* 3. What kind of time commitment are you willing to invest in such program? Do you envision this being a being a one-time call, a monthly engagement, or a longer-term mentorship?

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* 4. Is there a specific approach you would use?

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* 5. What do you consider to be your areas of strengths that mentees would find beneficial?

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* 6. Do you have any topics that you would not feel comfortable discussing with a mentee?

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* 7. Additional Questions/Comments

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