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HEADS UP Mentor Interest Form
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* Indicates required question
Name
*
Your answer
Email address
(Gateway Faculty/Staff, please use your GTC email.)
*
Your answer
Phone Number
*
Your answer
Are you Gateway Staff or Faculty?
*
Staff
Faculty
No. I am a community member.
Campus
*
Your answer
Mentoring Community Interest
*
General (Mentor a Gateway faculty student)
Nursing (Mentor a Gateway Nursing program student)
Veteran (Mentor a Gateway Veteran student)
Required
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