First Name *
Last Name *
Email Address *
Mobile Phone *
What is your gender? *
MaleFemale
What’s your professional role and current company ? *
What is the industry sector in which you work? *
e.g., Information Technology, media and communication, automotive, energy, healthcare, financial, etc.
How many years of professional experience do you have? *
1-2 years3-4 years5-10 years10 years or more
What is your primary motivation in joining the mentorship program (Check all that apply)? *
To give back to the communityTo influence the next generation of HCI professionalsTo develop mentoring skillsTo develop public speaking skills (presenting at the HCI seminars)To support my alma materTo recruit fresh HCI graduatesTo stay connected with academic developmentsOther
If you would like to elaborate on your answer above, please provide more (optional)
As a way to appreciate our mentors for the enormous contribution and sacrifice they make, we list them on our website (Name, Role and Company). Would you like us to add you to the list? *
YesNo
Are you a new or a returning mentor? *
NewReturning
Overall, what has worked well in the mentorship program?
Overall, what could be improved in the mentorship program?
Approximately, how many times and for how long did you meet with your mentee (s) over the last year?
How has the time commitment been for you? *
Just rightToo muchOther
How satisfied were you with the support provided by VarsityMentor for your mentorship activities? *
Very satisfiedSatisfiedNeutralUnsatisfiedVery unsatisfied
Would you be interested in continuing to mentor in the next academic year starting in late September of this year? *
YesNoMaybeOther
Would you like to be invited to speak at one of our training seminars in the future? *
YesNoMaybe
Would you like to recommend someone (e.g. a friend or colleague) to become our mentor? (If yes, provide their name and email address)
Please add any other comments or suggestions you might have.
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