Mentor Survey

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1. Please provide contact you information to help us matching you with the right Mentoring Group

Please provide contact you information to help us matching you with the right Mentoring Group Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP:
Country:
Email Address:
Phone Number:

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2. What is your current professional position?

What is your current professional position?

3. What is your current age group?

What is your current age group? 21-30

31-40

41-50

51 and above

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4. What is your higher level of education?

What is your higher level of education?

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5. Number of years of professional experience?

Number of years of professional experience?

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6. Describe your field(s) of expertise and/or professional interest?

Describe your field(s) of expertise and/or professional interest?

7. What areas most interesting to you in discussing with your Mentoring Group? (you can select more than one)

What areas most interesting to you in discussing with your Mentoring Group? (you can select more than one) Career Development skills

Academic jobs & tracks

Getting started in academia

Transitioning to industry

Alternative careers

Mid-career decisions

Challenges during work

Networking and job search

Balancing work and family

Management and leadership

Other (please specify)

8. Would you prefer to be in a Mentoring Group of peers who:

	Yes	No	No preference
Are of your age group?	*Would you prefer to be in a Mentoring Group of peers who: Are of your age group? Yes	Are of your age group? No	Are of your age group? No preference
Share similar professional background?	Share similar professional background? Yes	Share similar professional background? No	Share similar professional background? No preference
Have similar years of professional experience?	Have similar years of professional experience? Yes	Have similar years of professional experience? No	Have similar years of professional experience? No preference
Share your mentoring topic interests?	Share your mentoring topic interests? Yes	Share your mentoring topic interests? No	Share your mentoring topic interests? No preference

Other (please specify)

9. What are the good times and locations for you to meet with your Mentoring Group?

	Near home	Near work	No preference
Anytime	*What are the good times and locations for you to meet with your Mentoring Group? Anytime Near home	Anytime Near work	Anytime No preference
After work	After work Near home	After work Near work	After work No preference
During the work day	During the work day Near home	During the work day Near work	During the work day No preference
Weekends	Weekends Near home	Weekends Near work	Weekends No preference

10. Please add any comments regarding the survey questions or the AWIS Mentoring Group Program.

Please add any comments regarding the survey questions or the AWIS Mentoring Group Program.

Mentor Survey
Exit this survey

1. Default Section

*
1. Please provide contact you information to help us matching you with the right Mentoring Group

*
2. What is your current professional position?

3. What is your current age group?

*
4. What is your higher level of education?

*
5. Number of years of professional experience?

*
6. Describe your field(s) of expertise and/or professional interest?

7. What areas most interesting to you in discussing with your Mentoring Group? (you can select more than one)

8. Would you prefer to be in a Mentoring Group of peers who:

9. What are the good times and locations for you to meet with your Mentoring Group?

10. Please add any comments regarding the survey questions or the AWIS Mentoring Group Program.

Mentor SurveyExit this survey

1. Default Section

*1. Please provide contact you information to help us matching you with the right Mentoring Group

*2. What is your current professional position?

3. What is your current age group?

*4. What is your higher level of education?

*5. Number of years of professional experience?

*6. Describe your field(s) of expertise and/or professional interest?

7. What areas most interesting to you in discussing with your Mentoring Group? (you can select more than one)

8. Would you prefer to be in a Mentoring Group of peers who:

9. What are the good times and locations for you to meet with your Mentoring Group?

10. Please add any comments regarding the survey questions or the AWIS Mentoring Group Program.

Mentor Survey
Exit this survey

*
1. Please provide contact you information to help us matching you with the right Mentoring Group

*
2. What is your current professional position?

*
4. What is your higher level of education?

*
5. Number of years of professional experience?

*
6. Describe your field(s) of expertise and/or professional interest?