EmpowHER 2024 Mentor Registration
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Is this your first time being a mentor at EmpowHER?
*
Yes
No
What size t-shirt would you like?
*
X-Small
Small
Medium
Large
X-Large
XX-Large
XXX-Large
Food Choice
*
Sandwhich
Veggie Option
Training Date
*
Please Select
April 8 – 6-7 pm
April 11 – 12-1 pm
April 16 – 6-7 pm
April 20 - 7:30 am
How did you hear about becoming an EmpowHER Mentor?
*
I was a Mentor at a previous EmpowHER Retreat
A friend/co-worker
EmpowHER Social Media
RSO Email
A Facebook Group
Other
If you selected "other" above, please leave more details.
Submit
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