ACRS Mentoring Program 2024 - Mentors Please complete this survey before Friday 17 May Question Title * 1. Please enter your personal information: First Name Last Name Preferred Name Title Gender Country of Residence Email Address Question Title * 2. What is your time zone? (e.g., Queensland, Australia is Australian Eastern Standard Time (AEST)) Question Title * 3. Are you a member of the ACRS? Yes, I am an Individual Member of the ACRS Yes, I am a Corporate Member of the ACRS No, I am not a member of the ACRS Question Title * 4. Involvement as a Mentor requires a commitment to meeting with your Mentee regularly (at least one hour per month), at a time mutually beneficial for you both. Can you firmly make this commitment to meet regularly with your Mentee? Yes No Question Title * 5. Would you be willing to take on more than 1 Mentee? No Yes (please specify how many) Question Title * 6. Which of the following best describes the area of road safety you primarily work/ed in? Government Industry Research NGO Other (please specify) Question Title * 7. Are there any other areas you believe you could mentor in? Government Industry Research NGO Other (please specify) Question Title * 8. How long have you worked in road safety (years)? Question Title * 9. Please describe your road safety area of work and experience. Please provide enough information (e.g. areas of expertise or specialisation) to help us match you to a suitable Mentee. Question Title * 10. Other comments: Done