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Queer Mentor Application Form

Thank you for taking the time to complete this application form. The information you provide will help organizers match you with the right student(s).

Relevant information may be shared with mentees once a match is made and the midwife mentor has been informed of a possibility for a match. Midwives will have an opportunity to declare any conflict of interest with potential mentees before a match is made and the mentee is provided with any of your information. If you have any questions or concerns, please contact us at

Thank you!