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* 1. Your Information

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* 2. How many years have you worked as a PR professional?

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* 3. What industry are you in and is this where you feel you need guidance, or are you interested in being paired with a PR professional outside of your specific industry?

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* 4. What is your current job type (agency, non-profit, corporate, solo practitioner, government, health, etc.)?

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* 5. Tell us about your team.

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* 6. What are your strengths and areas in which you excel?

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* 7. What are areas where you’d like to be stronger and seek improvement?

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* 8. Describe a recent or current situation where you would have appreciated the opportunity to discuss the situation with a mentor. Explain why this situation was challenging and how you believe having a mentor would have been helpful.

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* 9. Are you looking for leadership guidance?

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* 10. Please list the top three goals you’d like to work on as part of this program?

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* 11. Is there anything else the Mentoring Committee should be aware of with regards to placing you with a mentor?

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* 12. Do you agree to and accept YOUR responsibility to coordinate with your assigned mentor?

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