Welcome to the Industrial Automation Mentorship Application

1

Name

First Name

Last Name

2

Do you think a mentoring session could support your career growth?

YESNO

3

What areas of automation interest you the most?

Industrial AI (OEE, anomaly detection, data dashboards)

Industrial Networking (PROFINET, Modbus, MQTT, OPC UA)

PLC Programming

Drives / Motion Control

HMI / SCADA Design

4

How would you describe your current experience level with PLCs?

Beginner

Intermediate

Advanced

5

Which PLC platforms have you worked with (or want to learn)?

Siemens (TIA Portal)

Codesys / Finder Opta / WAGO

Allen-Bradley (RSLogix / Studio 5000)

PLCnext (Phoenix Contact)

Other

6

What’s your current role or background?Example: Electrical technician, student, maintenance engineer, etc.

7

What is your top goal for the next 3–6 months?

Get good job in industrial automation

Finish my first Factory I/O project

Build a project portfolio for my CV

Build the first project with AI

Other

8

How many hours per week can you realistically dedicate to learning or project work?Type form 1-10

10

How much are you comfortable investing in your professional growth and learning over the next 6 months?

$100 – $200

$200 – $500

$500 – $1,000

$1,000 – $2,000

11

Are you ready to schedule a call with Matt Kurantowicz, your future AI & PLC coach?

YESNO

12

If after the 30-Minute Mentorship Call you felt fully confident that this program would help you reach your next career milestone, would you be ready to invest $1,949 USD to join the full 6-month mentorship?

YESNO

13

Type your e-mail and click submit to schedule a call* This field is required.

example@example.com

14

Appointment* This field is required.