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* 1. Contact Information

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* 2. Are you interested in being a Science Fair Judge? (check all that apply)

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* 3. What level of participation would you be interested in? (check all that apply)

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* 4. Please indicate your mentoring area(s) of interest (check all that apply):

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* 5. Are you currently involved in medical/science outreach for pre-college students?  Please describe below:

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* 6. Would you allow us to share your contact information with other science outreach programs or schools in the community? (based on your stated interests)

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