Am
I a Coach?
A survey has been developed to seek our feedback and needs as we offer a
coaching/mentoring training program. Please take a few minutes to complete
the survey
and return it as soon as possible.
Thank you for your interest and support of this effort.
Please check one of the following choices
1. Are you interested in pursuing an appointed or elected position?
_________Yes _________No _________Maybe
2. What position are you considering?
3. Would you like a mentor and the ability to network with like-minded
women if
there were these available resourses?
_________Yes _________No __________Maybe
4. Are you willing to commit time to meeting with a Mentor/Network group
of elected or
appointed women? _________Yes _________No __________Maybe
5. What skills do you possess currently to be a viable appointed/elected
candidate?
Please list:
6. What community service are you currently involved in?
7. What skill(s) will you need to develop or refine?
8. What type of support/help do you need?
9. Other comments or suggestions
Please complete and e-mail (copy and paste this page ) or print out and
mail to
Email:ddorgan2@msn.com
NWPC-Marin P.O. Box 113 Kentfield, Ca. 94914
Your Name ___________________________________________________________
Address_________________________________ City/Zip______________________
Telephone____________________________________________________________
EMail________________________________________________________________
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