Mentor enrollment form

If you'd like to be an AWC-DC professional mentor, please fill in this form and click on Submit form. Your experience and knowledge may be exactly the type of help a fellow member needs. If you need more information before you make a commitment, look at the information about the Professional Mentoring Committee or contact

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Natalie Doyle-Hennin Phone: 703-920-0783 (work)

For e-mail, fill in the form and click on Submit form. For U.S. postal-mail, print this form then fill in the requested information and send the form to the address given below.

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Your contact information:	Name: Title: Company: Street 1: Street 2: City: State/Country: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Canada International ZIP/Postal Code: Country (international only): Day Phone: Fax: Evening Phone: Preferred E-mail Address:
Contact preference:	Day phone Evening phone E-mail U.S. postal-mail
In which areas do you feel most comfortable giving advice?	The ins and outs of my field Practical how-to advice Management issues
My areas of expertise are one or more of the following:	Advertising and marketing Broadcast journalism Communications law Desktop publishing Direct mail Editing Fundraising Graphic design HTML and the World Wide Web Hiring and firing Intranet Lobbying and legislative affairs Management Market research Media relations Motivating staff Multimedia Negotiating contracts, compensation, and so forth Photography Print journalism Print production Radio and television (other than news) Public relations Small Office/Home Office (SOHO) Special events planning Starting/Owning your own business Teaching language or communications courses Telecommunications Technical communication Video and film production Workplace politics Writing Please specify particular expertise in software, hardware, or processes
Current and past places of work	College or university Congress Consulting firm Corporation Education K-12 Foreign employment Government Legal firm Media (television, radio, magazine, newspaper) Military Nonprofit Self-employment
AWC-DC projects you may want to be involved with:	Writing for the chapter newsletter Working on the Programs Committee Speaking at an AWC-DC program Volunteer communications work for a local charitable organization Other:
Preferred level of general communications experience of the mentee:	Entry level Junior level Middle management Senior management or executive
How many mentees are you able to mentor in one year?	1 or 2 3 to 5 6 or more Maximum number is:
Currently mentoring:
Resume available from:	URL FTP I will mail hardcopy I will fax hardcopy
Additional comments (optional):	What special challenges have you faced or experienced that you feel is worthwhile to share with another AWC-DC member or mentee (and that might not be reflected in your resume)?
Your E-mail address:

If your browser doesn't support forms, please use the form as a guide and send an e-mail message to nataliedoyle@mindspring.com or natalie@gofilnet.com with your information.

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