AMS Mentorship Questionnaire
Email address *
First Name: *
Your answer
Last Name: *
Your answer
I would like to be a:
Gender (requested as we will try to match up mentors/mentees accordingly): *
Phone Number: *
Your answer
Are you a member of Alice Mayo Society? *
How long have you lived in Rochester? *
What part of Rochester do you live in?
What department does your spouse work for? *
Your answer
Do you have children?
If you have children, what are their ages?
Your answer
Are you currently employed outside the home?
Please explain why you are interested in being a mentor/mentee. *
Your answer
Please check all the areas you are hoping to learn more about as a mentee or the areas you could provide expertise if you're a mentor. (Please check all that apply) *
Required
Are you willing to have us share your contact information with others to connect you as a mentor/mentee? *
Is there anything else you would like to share about yourself that might help us match you to a mentor/mentee? (language or cultural preferences, hobbies, interests, etc.)
Your answer
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