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MCSS Mentoring Plan
Mentors fill out this form after initial consultation with college.
Institution *
Your answer
Lead Contact *
Your answer
Email *
Your answer
Mentor #1 Name and Email *
Your answer
Mentor #2 Name and Email
Your answer
Date of initial consultation *
MM
/
DD
/
YYYY
Challenge Identified by institution *
Your answer
Desired outcome of Mentoring Engagement
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Suggested Length of Mentoring Engagement *
Date Mentoring Engagement will begin *
MM
/
DD
/
YYYY
Mentor Notes
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