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* 1. Contact info

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* 2. Would you like to be a Mentor or Mentee?

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* 3. Do you work in Streaming Media?

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* 4. How are women perceived in your company?

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* 5. Are there any women mentorship or networking programs at your company?

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* 6. How did you hear about the Women in Streaming Media mentor program?

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* 7. Please outline your current position with responsibilities

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* 8. What areas would you like to mentor/mentee in?

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* 9. Are you willing to devote an hour of time with your mentor/mentee every two weeks with action items between for a six month program?

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* 10. What are you looking for in a mentor/mentee and Is there anything else that you would like to describe about yourself that may help us find the best mentee/mentor for you?

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