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* 1. Name

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* 2. ATTUID

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* 3. Email

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* 4. How many years of service do you have

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* 5. Job Function

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* 6. What is your current classification?

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* 7. What is your current membership status:

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* 8. Please arrange mentor/mentoring circle in order or preferences

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* 9. What is one thing you would like to get out of your mentorship

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* 10. What (if any) are a couple of major challenges you are experiencing or trying to overcome in your role at this time

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