Name* First Last Title*Jurisdiction*Jurisdiction Population*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Point of Contact Phone*Point of Contact Email* # of years with this jurisdiction*Any previous jurisdictions? Yes No If Yes, Where? When?Member of TAMIO* Yes No If Yes, how long?Describe your job duties:In what areas would you like professional growth (mark all that apply):* Select All External communications Internal communications Crisis communications Strategic communications Website Development Social Media Strategy Special Event Marketing Video Production Citizen publications/newsletters Volunteer programs When being paired with a mentor, what is your preference for your partnership?* Similarly sized city Geographically close (within 90 minutes) Similar job responsibilities No preference
