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* 1. Please provide your contact information.

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* 2. What courses toward the CCIM designation have you completed?

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* 3. What industry segment do you have experience?

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* 4. How many years of real estate experience do  you have?

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* 5. What is your main objective of being a part of the Mentoring Program?

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* 6. Please describe the real estate industry that you are currently working in or would like to learn more about?

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* 9. How did you hear about the CCIM Mentoring Program?

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* 10. Are you affiliated with one of the CCIM University Alliance School Programs? Please select one.

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