2020 PNCWA Mentorship Program
Thank you for your interest in participating in the 2020 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 Andrew Matsumoto at
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 protege?
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?
Facility Operations and Maintenance
Equipment Manufacturer or Manufacturer Representative
What major areas of work are you interested in (select all that apply)?
Wastewater Treatment - Design
Wastewater Treatment - Operations
Wastewater Treatment - Maintenance
Collection System - Design
Collection System - Operations
Leadership and Management
Policy and Regulation
Public Education and Communication
Research & Development
Is there anything particular you'd like to focus on during your mentorship experience?
Technical Skill Development
Please describe your experience with PNCWA (choose all that apply).
Short School Planner
If you know who you would like for your mentor or protege, please specify.
Is the person indicated in the previous question the same person you were paired with last year, if applicable?
Do you mind if your mentoring team member is long-distance?
How would you prefer to communicate with your mentoring team member?
Can you commit to a minimum of 6 hr 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)
Once per week
Every other week
Once per month
Once per quarter
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