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* 1. First name:

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* 2. Last name:

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* 3. Email address:

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* 4. What is your role?

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* 5. Which department/unit are you a part of?

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* 6. Why are you interested in taking MobilizeU? (100 words maximum)

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* 7. What knowledge mobilization work/activities are you currently doing? (100 words maximum)

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* 8. How do you anticipate using what you learn in your work? (100 words maximum)

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* 9. How did you hear about MobilizeU at YorkU?

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