Registration Form for Women Seeking Parliamentary Mentorship
The fields marked with an asterisk * are mandatory.
MP Senator Representative Ex-Parliamentarian Other
Spanish Portuguese French English
Other:
Mailing Address : *
Phone number (s) you can be reached at:*
(Include area code e.g:613-555-5555)
Fax:
E-mail 1:
E-mail 2:
Website:
Date elected to office:
Mentorship Program
A) Which means of communications would you prefer using with your mentor?
Email Messenger (MSN, Yahoo) Fax Phone Other:
B) Would you be interested in participating in/ travelling to a face to face meeting of mentors and mentored?
Yes No
C) Would you be interested in contributing articles to the FIPA website and newsletter about your experience?
Experience and Interests
Should you require more space we invite you to send your résumés, biographies and CVs to us by e-mail at info@e-fipa.org
Professional, academic and volunteer experience:
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Date From - To
Personal areas of expertise and interest:
Should you have technical difficulties filling out this form, please contact : Technical support
