CAFPNA Mentor-Mentee Program_2016

*1. *1. Have you ever participated in Mentor-Mentee program before?

*2. *2. Name?  (Last, First)

*3. *3. At what email address would you like to be contacted?

*4. *4. Which of the following best describes your current occupation?

*5. *5. Would you be interested in becoming a mentor/mentee?

6. *6. If you are interested in being a mentor, please indicate your job title and the field you are currently in.

7. *7. If you are interested in being a mentee, what career path you would like to follow? Please sort the ans-wers with your choice and priority (If you are not interested in one of the three fields, then leave it out).

8. *8.  If you are interested in being a mentee, what do you want to learn from this program?

*9. *9.  If you are interested in being a mentee, what questions or topics do you care about? 

*10. *10. Which communication form do you prefer if you are involved in this program?

*11. 11. Any thoughts or comments?