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2019 MWM Be Counted! Campaign
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Name? *
Organization? *
Website? *
City/State and Province? *
Name of Event (if applicable, such as a specific summer camp)
Event Date (if applicable)
MM
/
DD
/
YYYY
How Many Girls/Women Were Mentored ( ie Mentees)? *
How Many Participated as Mentors? *
How Many Total Hours Did the Program, Event, or Mentoring Include? *
Age of Mentees *
Required
Brief Description of Program or Mentoring Activity *
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