Mentee Application
Only new youth need to fill out the form below. For any questions please contact Le"kedra Robertson at lekedra@micamped.org
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First name *
Last name *
Country *
Address *
City *
State *
Zip Code *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
What school are you currently attending? *
What grade are you in? *
What location of MIC will you be affiliated with? *
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