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* 1. Contact Information

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* 2. Areas of Expertise

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* 3. If you work in an agency, do prefer that your mentee:

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* 4. Do you expect to meet with your mentee outside of scheduled events? If so, how often? 

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* 5. Do you have a mentee in mind that you would like to be paired with? If so, please provide his/her name.

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* 6. Do you have any suggestions for 2015-16 Mentor Program events?

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* 7. PRSA membership is required to participate.

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* 8. Are you willing to take on more than one mentee? 

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