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* 1. Contact & Background Information

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* 2. Over the course of the program, participants are expected to schedule six one-on-one meetings with their mentor (est. 1 hour each). There will also be opportunity to join four full group webinars (est. 1 hour each). Are you able to meet this commitment?

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* 3. Program participants are also strongly encouraged to attend WQA's Convention or Mid-Year Leadership Conference (MYLC). Are you able to attend one or both of these in-person events?

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* 4. Briefly describe what you do and how you engage with the broader industry

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* 5. Who would benefit from your mentorship? List 2-3 characteristics/attributes of a mentee that would match well with you.

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* 6. Help mentees get to know you better. What happens outside of the office? Select up to 3 option below.

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* 7. What are your expectations for WQA and your mentee?

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