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2024-25 Future Leaders in Motion: Mentor Application
FPDA Future Leaders Program: Mentor Participation Form
Please complete the following:
I understand that this mentoring commitment is for a full 13 months, beginning in October 2024 and ending in October 2025.
Name:
Title:
Company Name:
Company Address:
City:
State/Province:
Zip/Postal Code:
Country:
Work Telephone:
Cell Phone:
Email:
Company Information:
Sales Category:
choose one
Under $2.5 Million
$2.5-5 Million
$5-10 Million
Over $10 Million
Company Type:
choose one
Distributor
Manufacturer
Number of Employees:
Products Distributed or Manufactured:
Main Product Brands (Distributors):
Area or Territory Covered:
What are some key business challenges your company is currently facing?
Personal Information:
Please give a brief description of your professional background (in 50 words or less):
Describe your current responsibilities:
Please list your key business skills and strengths (in 50 words or less):
What are some of your personal interests or hobbies?
Are there any other comments you would like to add?
Social Media Profiles:
Twitter:
Facebook:
Linkedin:
Instagram:
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