Mentee Application Form
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Name *
First and Last Name
Home Address *
Address, City, State, Zip Code
Email *
Phone number *
Will you be available to participate in online sessions on the below dates: July 18th, July 25th, August 1st, August 8th, and August 15th.  (sessions will run late morning)
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If you answered "No" to the previous question, please explain? *
University or High School *
What is the best way to contact you, initially? *
Summer Class Schedule (if applicable)
Course Name, Days, Time
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