First Name:
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Last Name:
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Home Address:
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Home Phone:
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Personal Cell:
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Hostos Degree:
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May we contact you at work? |
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Please specify what your time commitment would be and with what frequency: Please check all appropriate boxes
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Other Frequency:
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In what timeframes would you be available to give presentations? Please check all appropriate boxes
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Other Timeframe:
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What is your area(s) of expertise? Please check all appropriate boxes
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Other Area of Expertise:
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Bio:
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