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We would love to hear from you, please complete the form below,
and someone from the team will get back to you within 1 business day.
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Name
*
First
Last
Phone
Email
*
Are you a business or organization?
*
Business/Organization
Potential Mentorship Candidate
Name of your business/organization
Type of business/industry
*
# of years in business
*
# of employees
*
Do you offer health insurance / 401k retirement benefits
*
Health Insurance
401k Retirement Benefits
Both
Neither
How did you hear about our organization?
*
Age
*
High school grade
*
Currently working? If so, what job:
*
Currently enrolled in BOCES classes?
Yes
No
What town do you reside in?
*
How did you hear about our organization?
*
Why are you joining? What are your interests?
Submit
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