Name *

First Name

Last Name

Phone *

We won't randomly call you! It just helps us understand your location.

Country

(###)

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1. In which capacity do you want to join our Network? *

You might want to offer advice only,

Mentor Contributor (I feel I have great experience and want to share with others)

Mentor & Mentee (I have lots to give and also looking to grow and seek advice)

Mentee (I have lots of questions and would love advice)

2. What are you hoping to achieve by joining our network? *

Tick as many as apply.

Access to experience not available in my country/region

Access to women outside my industry

I have specific work related challenges and would love input from talented experts

My company is small and I want access to leaders with experience

I want to grow by learning from others

I want to offer my years of wisdom and experience to others (Mentors only)

Other

3. How would you describe yourself? *

Tick one.

A senior leader in my business/industry

Looking to retire and have a wealth of knowledge

Just starting out and want access to powerhouse women to learn from

In the middle of my career and want to progress

Other