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* 1. Your Name

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* 2. Your Mentee's Name

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* 3. Please select report month.

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* 4. Have you been able to connect weekly with your mentee?

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* 5. What is new with their pregnancy or child?

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* 6. What activities are you working on together? (Check all that apply) *NOTE* All activities can be found at www.hmhbpbc.org/ccresources

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* 7. We love success stories.  Please share something amazing that you and your mentee did this month.

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