Intake & Matching Questionnaire | Brotherhood in Media

1. About You

I am applying as *Full name *Email *

PhoneCity / Market

Employer / OutletRole / Title

Years in media

Coverage area / beat

Primary Journalism PlatformPlatform preference for your match

Career goals for the next 12 monthsPreferred mentoring style

General availability

Preferred meeting frequencyPreferred contact method

How important is a direct match in subject area and platform?

3/5

1 = not important • 5 = essentialImportance of geographic proximity

3/5

1 = not important • 5 = essentialImportance of leadership development focus

3/5

1 = not important • 5 = essentialAnything else we should know?