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DMD Mentee Application

Apply Here
Name of School/Learning Center
Current Education Level

CAREER INTERESTS
Describe one or more Jobs/Careers that interest you and explain why:

Have you participated in Disability Mentoring Day in the past?
Will you need any accommodations to participate in DMD such as alternative format? (Braille, Large Print, Sign Language Interpreters etc.)

SCHOOL OR PROFESSIONAL CONTACT:

(Teacher, Para-professional, Counselor, Service Provider)

Will this student require special transportation/PARA?
Any special dietary restrictions?
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