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Mentee Intake Form
General Information
Name
*
First
Middle
Last
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Phone
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Email
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Discipline
Select a primary skillset that interest you
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Account Planning
Account Services
Analysis
Copywriting
Creative Development
Event Coordination
Finance and Accounts
Media Buying
Media Planning
Production
Public relations
Research
Web Development
Select a secondary skillset that interest you
*
Account Planning
Account Services
Analysis
Copywriting
Creative Development
Event Coordination
Finance and Accounts
Media Buying
Media Planning
Production
Public relations
Research
Web Development
Select a tertiary skillset that interest you
*
Account Planning
Account Services
Analysis
Copywriting
Creative Development
Event Coordination
Finance and Accounts
Media Buying
Media Planning
Production
Public relations
Research
Web Development
Education
Highest Level of Education
*
High School
Associate Degree
Bachelor's Degree
Graduate or Professional Degree
Some College
Other
Prefer Not to Answer
Major
Minor
Name of Institution
Are you currently enrolled?
Yes
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Career Goal
Work environment have you experience in
*
Agency / Consultant
In-house
Freelance
Employment
*
Employed Full-Time
Employed Part-Time
Self-employed
Student
Prefer Not to Answer
Are you currently looking for new employment opportunities?
*
Yes
No
Where do you see yourself within the next 5 years? (75 words)
*
About you
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Bio
*
Tell your future mentor a little about yourself (75 words)
Share three things you hope to gain from this mentorship experience?
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