UCSF CURE Mentor/Host Interest Form

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UCSF CURE Mentor/Host Interest Form

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* Indicates required question

First Name *

Your answer

Last Name *

Your answer

Preferred Pronoun(s)

Your answer

What is your email address? *

Your answer

What is your role/position? *

Graduate Student

Faculty

Lab Manager

Postdoc

Other:

Required

What is the name of your department? *

Your answer

What is the name of your lab? (Please feel free to link website if applicable) *

Your answer

Questions/Comments

Your answer

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