Women in Tech Leadership Mentorship Program Question Title * 1. What is your full name and email address? Name Email Address Next Question Title * 2. What is your current title/position? How many years have you been in this position? How many years total have you been in the workforce? Current title/position? Years in current position? Total years in workforce? Next Question Title * 3. What county do you WORK in? What county do you RESIDE in? Work? Reside? Next Question Title * 4. Are you interested in the participating in our Mentorship Program? If so, to what capacity? Yes, as a mentor Yes, as a mentee Both I'm not sure, but need more information Not at this time Next Question Title * 5. How much time would you be willing to commit to this program? 1-2 hours a month 3-4 hours a month 5+ hours a month Other (please specify) Next Question Title * 6. When would be the best time for you to contribute to the program? Mornings Afternoons Evenings Next Question Title * 7. Outside of the initial face to face meeting, what is the best form of contact you would prefer? Face to face meetings Skype / FaceTime / Google Hangout meetings Phone calls No preference Next Question Title * 8. What topics would you be interested in? Please check all that apply: Career Planning Work/Life Balance Leadership/Team Work Professional Challenges Other (please specify) Next Question Title * 9. Have you ever participated in a mentorship program? If yes, for how long and to what capacity? Yes/No? How long? (N/A if not applicable) Mentor/Mentee/Both? Next Question Title * 10. What training would you find helpful? Is there anything else we should know? Next DONE