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* 1. Contact Name:

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* 2. Organization Name:

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* 3. Phone Number/Email:

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* 4. website:

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* 5. Please briefly describe your organization:

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* 6. We ask that organizations be prepared to host one or two Moxie Scholars for 32/week for 8 weeks. Please briefly describe the internship position and responsibilities.

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* 7. What kind of benefit would collecting oral histories have for your organization?

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* 8. Would your organization like to work with one or two Moxie Scholars?

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