Please share with us your contact information.  Your address will not be shared with your mentees.  This is only for internal project purposes.

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* 1. Contact Information

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* 2. Are you interested in participating in the AAKP Peer Mentorship Program (a 6-month pilot program)?

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* 3. What is your preferred method of interacting with Mentees? (Please check all that apply.)

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* 4. Are there any times throughout the week that you are not available to communicate with mentees?  Please list times below.  We understand this may be subject to change.

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* 5. How did you hear about this mentorship program?

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* 6. Did you, or do you currently, have a mentor who has helped, or is helping, you navigate your personal journey with kidney disease?

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