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halo house Intake
Mentor and Mentee Intake Form
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Email
*
Your email
Personal Details
First, tell us a bit about yourself
Name
Your answer
Gender
Female
Male
Prefer not to say
Other:
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Age
15-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65 years +
Clear selection
Where are you based?
Available virtually
Available in-person (Sydney, London, NYC only)
Sydney
Rest of Australia
New York
Rest of US
London
Rest of UK
Other
Available virtually
Available in-person (Sydney, London, NYC only)
Sydney
Rest of Australia
New York
Rest of US
London
Rest of UK
Other
Clear selection
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