(A copy of this form will be e-mailed to the e-mail address you enter below. However, you may wish to copy your responses prior to submitting the form in case of unforeseen errors)

Your Information:

Your Name (required)

Your Email (required)

Cell Phone:

Contact by Text?

YesNo
Other Phone:

Mailing Address (required):

City:

State:

Zip:

Student Status:

Graduation Date:

Company

Your Web Site Address (if you have one)

Your Birthday! (month and day only)

Chapter Membership: Please Choose One (required)

—Please choose an option—PhoenixNew YorkAddisonFlower MoundNorth DallasNorth Fort WorthRed RiverUT DallasOther New Chapter*No Chapter Affiliation - I want to be a Member-At-Large

Is the above choice a transfer? yesno
*If you entered "Other New Chapter" please enter more info here:

What advantages and opportunities are important for you to receive from WOVI?

Please check any or all that apply.

MentoringLeadershipEducational ProgramsEmpowermentProfessional GrowthParticipatory ProgramsCommunity ServiceRelationshipsService to Women

What are your professional/career goals/aspirations? (required)

What are the strengths and experiences you are willing to share with another member in the capacity of mentor? (required)

What experiences, attributes, knowledge and/or skills do you want your mentor to have? (required)

Please choose the committee(s) you want to participate on or hear more about:

CommunicationsMembershipMentorProgramsMember ServicesInterest RingsAnnual ConferenceMentor Recognition LuncheonMentor Certification

Please Include Any Message You'd Like To Add:

Please enter below the characters you see above (this is for security and is required):

By clicking the Send button, you acknowledge that the advice and input you receive from your assigned mentor is the opinion or recommendation of the person presenting it and does not, in any way, represent WOVI, Inc. or any of its Chapters.

(A copy of this form will be e-mailed to the e-mail address you entered above. However, you may wish to copy your responses prior to submitting the form in case of unforeseen errors)

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