Blue Scarf Society Sign Up

Name *

First Name

Last Name

Phone

Please provide your preferred contact phone number.

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The above phone number is my:

Work phone

Mobile phone

Home phone

Mentorship: If you are interested in the mentorship program, please select one of the following:

A separate mentorship questionnaire will be emailed to you to assist with pairings.

I would like to be paired with a mentor.

I would like to mentor someone.

If you would like to participate in our Blue Scarf Society committee, helping to plan and execute future programming, please let us know below.

Yes, I am interested in joining this committee. Please contact me with more information.

No thanks, I wish to be a member but I don't have the capacity to serve on a committee.