Name
(Required)
Please provide your full name.
What is the name of your company or, where are you are employed?
(Required)
Telephone Number
(Required)
In case we need to connect with you.
Your Email Address
(Required)
What is the size of your company?
(Required)
Describe any challenges or barriers you are facing as a young professional?
(Required)
Please note: Young is not necessarily referring to age but includes young in your career.
Please select the top three (3) issues you would feel confident addressing with a mentee?
(Required)
Professional growth
Imposter syndrome
Promotions & Raises
Career pivots
Work-life balance
Parenting
Detailing with personal transitions
Mental Health
What is your preferred way to connect?
Email
Phone
Video
Text
Mix between Phone and Video
Other
Why are you seeking a mentor?
(Required)
Please describe your career or educational journey.
(Required)
What insights would you hope to gain from your mentor?
(Required)
Are you a member of Women in Energy?
(Required)
Yes
No