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LEAP LAND LIVE Mentorship Waitlist
Please fill out this form in its entirety.

The Nine Lives Health Team will be in contact with you regarding next steps once all of the applications are reviewed. We will begin this process in July for an August 2019 start.

Please email with any questions.

Email address *
Full Name *
Your answer
Instagram Handle *
Your answer
When it comes to my job and my schedule what are the top THREE things I am most dissatisfied with? *
Your answer
Are you currently trying anything to better any one of the three things you listed above? If so, which one and how? *
Your answer
How long have you been a nurse? *
What kind of nurse are you? *
Your answer
What do you think having a mentor will do for you? *
Your answer
Why is this the right time for me to invest in mentorship? *
Your answer
How do you want to LEAP? *
Your answer
What is holding you back from taking a chance on something new? *
Your answer
A copy of your responses will be emailed to the address you provided.
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