The ATCG Mentorship Challenge

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1. Name:

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2. Email Address

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3. Confirm email address

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4. Phone number

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5. State/Country in which you live

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6. Your profession

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7. Age group that you would like to mentor

Elementary School

Middle School

High School

College

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8. Explain why you would like to be a mentor

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9. Provide a professional web page or social media page so that your identity can be verified