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BC HIMSS Mentee Application Form
Welcome to the BC HIMSS Mentorship program. Please fill out the following form to become a Mentee in the program. Your participation is valued!
This form will take about 10 minutes to fill out
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First Name
*
Your answer
Last Name
*
Your answer
eMail Address
*
Your answer
Current Role/Title
Your answer
Current Organization
Your answer
Are you a BC HIMSS Chapter Member?
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BC HIMSS Membership #
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