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YLA Mentor Application
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First and Last Name
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Your answer
Email address
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Your answer
Phone #
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Your answer
Business/Company
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Your answer
Current job title (if applicable)
Your answer
Current job responsibilities
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Your answer
Are you able to commit to 6-7 afternoons (11:45 am - 1:00 pm) within an academic year to attend workshops?
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Yes
No
I understand that I will possibly be expected to follow up with my mentee(s) after workshops and occasionally check in with them throughout the school year to see how they are doing.
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Yes
No
How did you hear about the YLA mentorship program?
Your answer
Why do you want to become a YLA Mentor?
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Your answer
What strengths or skills do you think you will be able to bring to your mentee(s)?
Your answer
What special interests do you have that might help us better match you to your mentee(s)?
Your answer
Do you have any additional information or comments?
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