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* 1. I am interested in participating in a CPRS Manitoba Mentorship Program that links (check all that apply):

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* 2. If interested in participating in a mentorship program, what role is of interest to you? Check all that apply.

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* 3. CPRS Manitoba is considering hosting events for participants in the CPRS Manitoba Mentorship Program. At what time(s) would you be available for Mentorship events (either private meetings or group events). Check all that apply.

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* 4. If interested in participating in a mentorship program, would you be willing to commit to monthly meetings and other forms of communication from October 2015 to April 2016?

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* 5. What interests you most about participating in a mentorship program? Check all that apply.

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* 6. How long have you been working in public relations?

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* 7. How long have you been a member of CPRS Manitoba?

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* 8. Please provide any comments, questions, or concerns you may have regarding a mentorship program, or membership in CPRS Manitoba.

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