This information is used solely for the BWiC Build Her Mentor Program.

Only AGC MA will have access to this information.

Your responses will be kept private and secure.

The information will not be used for a discriminatory purpose.

You can change this information in the future by resubmitting the survey.

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* 1.  Name

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* 2. Email Address

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* 3. Employer & Job Title

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* 4. Where do you live (for travel logistics)

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* 5. Industry Experience (years in the industry, titles, certifications, association experiences, personal accomplishments)

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* 6. How do you self identify? (Mentees may indicate a match preference in terms of gender identification, sexual orientation, race, or any other demographic) Response is optional.

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* 7. What skills you are comfortable sharing?

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* 8. What strategies have you employed when dealing with a difficult situation?

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* 9. What is the first step you typically take to achieve a preferred outcome?

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* 10. How have you recognized that you have mastered or successfully enhanced a competency?

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* 11. What’s your personal value proposition?

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* 12. Are you prepared to commit to regularly scheduled live & virtual meetings (monthly at minimum) with your mentee and the larger group)?

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* 13. What has inspired you to be a Mentor?

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