2022 WTS-LA Mentorship Program Questionnaire
WTS-LA Members are invited to participate in this unique career-enhancing program geared towards mid-career protégé professionals.

The WTS-LA Mentorship Program will last through the end of 2022.  Your commitment in the program will include:  group events held every other month, starting in Spring 2022 (such as zoom meetings and workshops), as well as one-to-one meetings with your mentor/protégé once per month.

The program is open to current WTS-LA Members and space is limited.

In addition to completing the questionnaire below, please submit your resume to mentorship@wtsla.org by Tuesday - March 1, 2022 so the Mentorship Committee can match you in a mentoring relationship.

We look forward to your participation in the 2022 WTS-LA Mentorship Program as a Mentor or Protégé!
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1) First and Last Name *
2) Job Title *
3) Company *
4) Email Address *
5) Cell-phone Number *
6) In an effort to pair mentors and protégés in close proximity, please provide preferred meeting locations: *
7) Are you a current WTS-LA member (mentorship program requires membership in WTS-LA)? *
8) In which position are you interested? *
Required
9) How many years of experience do you have in your field? *
10) Which industry best represents what you do? *
11) What do you hope to gain from participating in the Mentorship Program? *
12) What types of mid-career programs are you interested in for the Mentorship Program group events?  In which areas are you interested in developing yourself professionally (for example: leadership skills, presenting in virtual space, understanding your client…)? *
13a) What is most important to you when being matched with a mentor/protégé?                                          I would like to be matched with someone:  within my industry only. *
Not Important
Very Important
13b) I would like to be matched with someone:  outside my industry. *
Not Important
Very Important
13c) I would like to be matched with:  female *
Not Important
Very Important
13d) I would like to be matched with:  male *
Not Important
Very Important
14) Please identify any special circumstances that we should be aware of when matching you with a mentor/protégé (e.g. conflict of interest situations).  If none, state "n/a." *
15) Which of the following method(s) do you prefer to communicate with your mentor/protégé?  Select all that apply. *
Required
16) What is your preference for meeting days?  Select all that apply. *
Required
17) The WTS-LA newsletter will highlight mentorship events throughout the duration of the program.  Do you give WTS-LA permission to use your photograph in the newsletter? *
18) Is there anything else the Mentorship Committee  should know?
19) By submitting this application form, you agree to the "WTS-LA Confidentiality and Disclosure Commitment" written below.  Please confirm you have read and agree to the "Confidentiality and Disclosure Commitment" by typing your name below as your signature, and indicating today's date. *
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20) Did you email your resume to mentorship@wtsla.org? (Name the file "2021_Mentor_LastName_FirstName" or "2021_Protege_LastName_FirstName") *
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