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* 1. What is your name?

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* 2. What is your street address?

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* 3. What is your phone number?

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* 4. What is your email address?

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* 5. Tell us about your work history.

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* 6. What do you think makes a good mentor?

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* 7. Why do you want to be a mentor for the JOBS Program?

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* 8. What aspect from your life will help you with mentoring?

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