PRSA Rochester - Mentor Registration (form)

Advisory Network

* First Name:

* Last Name:

* Title/Occupation:

* Company/Organization:

* Email Address:

* Phone (with Area Code):

* Are you a PRSA member?

* How many years experience do you have in the industry?

* Your Current Organizational Setting:

Other (Current Organizational Setting):

* Areas of Expertise (Select Top Choice):

Other (Area of Expertise Top Choice):

* Areas of Expertise (Select 2nd Choice):

Other (Area of Expertise 2nd Choice):

* Areas of Expertise (Select 3rd Choice):

Other (Area of Expertise 3rd Choice):

Areas of Expertise (Select 4th Choice):

Other (Area of Expertise 4th Choice):

* Please write a brief description of your work responsibilities.

* How do you prefer mentees to first contact you (e.g. phone, email, etc.)?

Which tier would you like to be registered as within the PRSA Advisory Network?

Small group-based mentoring: Opportunities for mentors to occasionally meet with small groups of students/mentees – facilitated by YPRP.
Project-based mentoring: Opportunities for mentors/mentees to collaborate on specific project(s) for a designated period of time – whether a resume, portfolio-building or another project.
Informal/informational interview mentoring: Opportunities to occasionally and selectively connect for one-to-one informational interviews, brief phone exchanges, or via email, for specific questions.

Please select all that may apply:

Small group-based mentoring

Small_group_based_mentoring

Project-based mentoring

Project_based_mentoring

Informal/informational interview mentoring

Informal_informational_interview_mentoring

Please share any additional information or comments you may have.

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