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WIN Mentoring 2024
WIN Membership Mentoring Program
Help us to help you!
WIN is all about helping one another grow, so please complete this membership survey as we would
love
for you to provide input on what you would like to see this year at WIN.
Thank you!
*
1.
What is your first name?
(Required.)
*
2.
What is your last name?
(Required.)
*
3.
What is your (state) email address?
(If you do not have a state email address, please add your preferred email)
(Required.)
4.
What is your contact number?
(Optional)
5.
Are you a WIN Mentor or Mentee?
Mentor
Mentee
Volunteer as a Mentor
Enroll as a Mentee
*
6.
What is your agency's acronym? (DHSH, DES, EST, DOT etc.)
If you do not work for a WA state agency, please enter PRIVATE or NON-PROFIT.
(Required.)
7.
What interested you in participating in WIN's mentoring program?
8.
Do you have any suggestions about presentations or topics for upcoming mentoring events? If yes, please share with us.
9.
How frequently would you like to connect with other WIN mentors and mentees?
10.
Would you like to present or share your experience at an upcoming WIN mentoring meeting or event?
Yes
No
11.
If you selected Yes to the above question, please add your presentation topic.
12.
What is the best way to connect with you?
Email
Phone
13.
Do you have any additional comments or suggestions you would like to add?
