Expression of Interest for ACIITC Mentoring Program

Question Title

* 1. Full Name (First Name, Last Name)

Question Title

* 2. Please select your gender

Male

Female

Other (please specify)

Question Title

* 3. What is your age?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

Question Title

* 4. Job Title

Question Title

* 5. Company/Organisation

Question Title

* 6. Phone Number

Question Title

* 7. Email Address

Question Title

* 8. How did you hear about the ACiiTC Mentoring Program?

Newsletter

ACIITC

Word of Mouth

Other (please specify)

Question Title

* 9. Which category interests you?

Incorporating technology into Strategic Plans

Planning investment in technology

Building Networks and relationships in the sector

Technology and innovation workplace practices

Digital Strategies

Information governance and reporting

Building networks and relationships in the sector, specifically global networks

Upgrading technologies

Incorporating technology into Strategic Plans (in general terms)

Cybersecurity practices

Question Title

* 10. In 25 words or less explain what stage of your career/ business you are in (i.e beginning, concept or looking to progress to another stage)

Question Title

* 11. In 250 words or less tell us why mentoring would benefit you

Question Title

* 12. Would you be able to commit to 1 meeting a month?

Yes

Question Title

* 13. Have you been involved in a mentor/mentee program before?

Yes

Expression of Interest for ACIITC Mentoring Program

Question Title

* 1. Full Name (First Name, Last Name)

Question Title

* 2. Please select your gender

Question Title

* 3. What is your age?

Question Title

* 4. Job Title

Question Title

* 5. Company/Organisation

Question Title

* 6. Phone Number

Question Title

* 7. Email Address

Question Title

* 8. How did you hear about the ACiiTC Mentoring Program?

Question Title

* 9. Which category interests you?

Question Title

* 10. In 25 words or less explain what stage of your career/ business you are in (i.e beginning, concept or looking to progress to another stage)

Question Title

* 11. In 250 words or less tell us why mentoring would benefit you

Question Title

* 12. Would you be able to commit to 1 meeting a month?

Question Title

* 13. Have you been involved in a mentor/mentee program before?

Question Title

* 14. If you answered yes to Q13, which program were you involved in?

Question Title

* 15. What goals are you looking to achieve from the mentoring program?

Question Title

* 16. Any other comments or information you would like to share?