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* 1. What is your name?

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* 2. What is your 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. What company/organization are you affiliated with?

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* 6. What personal and professional leadership skills would you like to develop through the mentoring program? 

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* 7. What are your career goals? How will the mentoring program help you achieve those? 

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* 8. Describe your ideal mentor. What type of communication and leadership styles work well for you in your current career? 

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* 9. This is a program that will run for August 2021-May 2022. Are you able to commit to the time frame?

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* 10. The WLR Mentoring program will have in person events scheduled throughout 2021-2022. The program success is critical to in-person meetings. Are you available to commit to that for the next year?

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