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* 1. Today's date:

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* 2. Your name:

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* 3. Please list any designations you have.

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* 4. Your title:

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* 5. Your employer: 

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* 6. What is your preferred mailing address?

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* 7. Preferred phone:

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* 8. Preferred email:

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* 9. What city, state, country do you reside in?

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* 10. Number of years as a member of SITE?

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* 11. Number of years in the incentive industry?

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* 12. I am a:

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* 13. If meeting planner, what arena?

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* 14. If supplier, what arena?

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* 15. If you are a student, where are you currently enrolled?

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* 16. Please briefly describe any volunteer work you may have in the past five years (in any organization and does not have to be in our industry).

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* 17. Why do you want to be a mentee in this program?

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* 18. My ideal mentor would have these traits or characteristics:

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* 19. What are your top two (favorite) personality traits? This question is about you, and traits you have (not wish you had). 

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* 20. If you would like a mentor in a specific field or industry, please note that here, and tell us why that is important to you. We will do our best to honor your preferences.

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* 21. Please list two hobbies or something unique about yourself.

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* 22. Have you participated in a Mentor program before? If so, please share briefly about your experience.

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* 23. Are you able to suggest one other colleague in our industry that you would like to recommend for our mentor program?

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* 24. Please provide at least one reference from your SITE chapter. 

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* 25. Please provide any additional information you would like us to know about you at this time.

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* 26. By submitting this form, you agree to service as a mentor in the SITE Texas Mentor Program and acknowledge you have read and agree to the guidelines in the Mentor Program Guidebook. 

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