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* 1. Please provide your name, section & contact email

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* 2. How many SWE members would you be willing to mentor?

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* 3. What is your engineering discipline?

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* 4. At what stage are you in your career?

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* 5. At what stage are you in your SWE career? (Please choose the highest level of office you have held)

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* 6. Do you have a preference about whether your mentee is someone in your same section?

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* 7. Please specify the area(s) you'd like to mentor someone on

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* 8. Are you willing to make contact with your mentee at least once a month through the duration of the program?

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* 9. Is there anything specific you'd like us to consider when matching you to a mentee?

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* 10. How can we make this program work for you? Please provide comments on ways we can support you or improve the program.

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