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SEA Mentorship Application
First Name *
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Last Name *
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Email: *
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City: *
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State: *
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Social Enterprise: *
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Parent Organization: (Applicable only if your social enterprise belongs to a larger organization.)
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Organization Incorporation Type: (select all that apply) *
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Please provide a brief description of your social enterprise/the social enterprise that you work for: *
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Job title: *
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Describe your role and main responsibilities within the social enterprise: *
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Are you a dues paying member of Social Enterprise Alliance? *
Which of the following best describes you: *
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