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In Reach Maverick Mentor Program

Mentee Nomination Form

Please provide the following information for the student you wish to nominate.

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For the nominator to complete (you can self nominate).

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Rate the following characteristics of the nominee from 1 (weak) to 5 (strong).

Describe the nominee in 3 words.

Answer the following questions about the nominee.

Thank you for your nomination.

Maverick Connect: In Reach Maverick Mentor Program