2022 PNCWA Mentorship Program
Thank you for your interest in participating in the 2022 Pacific Northwest Clean Water Association Mentorship Program! This survey is used to help us pair program participants with similar interests. If you have any questions, please contact the PNCWA Students and Young Professionals Committee Chair Erica Haide at ehaide@brwncald.com.
Sign in to Google to save your progress. Learn more
What is your name? *
What email should we use to contact you? *
What phone number should we use to contact you? *
Are you signing up to be a mentor or protégé? *
Who is your current employer? If you are a student, what school do you attend? *
What is your current position? If you are a student, please list your degree(s) and major(s). *
In what city or region do you currently live or work? *
How many years of professional experience do you have? *
What (has been)/(will be) your primary career track? *
What major areas of work are you interested in? (select all that apply) *
Required
Is there anything particular you'd like to focus on during your mentorship experience? (select all that apply)
Please describe your experience with PNCWA (select all that apply) *
Required
If you know who you would like for your mentor or protégé, please specify.
Is the person indicated in the previous question the same person you were paired with last year, if applicable?
Clear selection
How would you prefer to communicate with your mentoring team member?
Clear selection
Can you commit to a minimum of 6 hours over the course of the year? *
How often would you like to interact with your mentorship program partner? (Select the closest option to your desired level of interaction)
Clear selection
Any other comments?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms