WSS Mentor Program Matching Form 2018-2019
WE ARE NOT ACCEPTING ANYMORE MENTEES AT THIS TIME. WE ARE AT CAPACITY. PLEASE FILL OUT THIS FORM IF YOU ARE SIGNING UP AS A MENTOR ONLY.

Welcome. We need some basic information in order to register you for the program and to match you with a participant. You could additionally send a CV to theresa.kim@gmail.com. The survey responses will be used only for matching and only mentoring committee will have access to the information. We are planning happy hour and holiday party events this autumn. We can answer questions about the program; you can meet other participants and also established mentor-mentee pairs.

Email address *
Name *
Your answer
Phone number *
Your answer
Desired role in program *
Where do you live? *
Your answer
Where do you work or attend school? *
Your answer
Degree and field of study (completed or in progress)? *
Your answer
Years worked in profession
What are your goals for the mentor/mentee program? *
Your answer
What are your statistics interests? *
Your answer
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