Exit this survey 2014-2015 NYWICI Foundation Mentee Application Please note: At this time, only current Student Members or Young Professional Members of NYWICI are eligible for this program. If you are not currently an active Student or Young Professional Member of NYWICI, you may join online at www.nywici.org/membership. Question Title * 1. First Name Question Title * 2. Middle Initial Question Title * 3. Last Name Question Title * 4. Primary Email Address Question Title * 5. Mobile Number: Question Title * 6. Date of Birth/Age Question Title * 7. Are you a current Student or Young Professional Member of NYWICI? Student Member Young Professional Member Question Title * 8. Are you currently enrolled in an undergraduate or graduate program? Yes No Question Title * 9. Name of college or university Question Title * 10. Anticipated year of graduation Question Title * 11. Are you working? Part-time Full-time No Question Title * 12. If working, are you an intern or employed? Question Title * 13. Company Name Question Title * 14. Title Question Title * 15. Address Question Title * 16. City, State, Zip Question Title * 17. My career objectives lie in the following areas: Advertising Books Broadcasting Corporate Communications Data Management/Analysis Digital/New Media Film and Video Fundraising/Development Graphic Design Journalism Magazines Marketing Multimedia Newspapers Photography Publishing Public Relations Radio Television Writing/Editing Other, please specify Question Title * 18. What do you hope to gain from participation as a mentee? Question Title * 19. Briefly describe yourself and your goals. Question Title * 20. Briefly describe your ideal mentor. Question Title * 21. I understand that due to program limitations I may not be matched with a Mentor at this time. Yes No Question Title * 22. In 2014-2015 we are introducing a more flexible mentoring program. Please indicate your preference: I am interested in a very short term mentor (1-3 months) I am interested in a 6 month mentor commitment I am interested in a 1 year mentor commitment Question Title * 23. Would you be interested in Reverse Mentoring: an opportunity for young professionals to mentor seasoned professionals in areas across media and communications (such as print, web, mobile, social, video or data management/analysis)? Yes No Directions: Please answer the questions below and send your current resume or bio via email to Angella Giannacopoulos (AGiannacopoulos@kellencompany.com). Terms: I agree, as a potential mentee, to communicate effectively with my mentor, follow up on discussions and follow through for the agreed-to terms of the mentor/mentee relationship. Terms of the relationship, including type/regularity of communication will be set after mentor/mentee matches are made. Submit