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Mentorship Program Application
Mentorship Program Application
Innovation
2022-09-03T15:56:04-04:00
Mentor Application
Name
First
Last
Email
LinkedIn URL
Job Title
Company
How long have you been in your current role?
Describe your job responsibilities in a few sentences.
What career aspirations do you have for the next 3-5 years?
List any personality assessment types (CliftonStrengths, 16personalities, etc) you’d like to share (optional)
What do you think are 2-3 of your strongest professional strengths?
What adjectives describe your personal temperament?
To help us make a strong connection between mentors and mentees, please feel free to share a few of your top personal passions.
As a mentor, what role do you think you can serve for your mentee? (Select all that apply)
Colleague (Acts as a peer mentor. Provides different perspective; could lend aid in professional skills)
Nurturer (Seeks to grow already established skills. Uses empathy)
Listener (Becomes a sounding board. Uses active listening techniques to help mentee arrive at conclusion)
Teacher (Aids in helping mentee learn new skills. Seeks to improve skill sets)
Motivator (Seeks to inspire mentee to reach goals, determining and using appropriate techniques. Positive influence and builds confidence in mentee)
Career Development (Helps mentee outline career path and goals. Seeks to be an advocate for mentee)
Life Coach (Aids in personal and professional goal setting. Supports mentee overcoming personal obstacle)
Select All
In what area do you feel you could provide the most insight/value to a mentee?
Leadership Development - Help prepare current and future leaders to perform effectively in their roles and build their competency as a leader.
Work/Life Balance - There are many aspects of one's personal life that can intersect with work. Work with a mentee who needs help navigating that balance so they can set and reach goals in the workplace and at home.
Listener (Becomes a sounding board. Uses active listening techniques to help mentee arrive at conclusion)
Overcoming barriers (race, gender, ethnicity or other demographics) - Even though the collective and included experiences, identities, and ways of thought or interaction of people from diverse backgrounds are producing great outcomes for companies, the roadblocks to overcome are many. Work with a mentee to talk through those barriers they might be facing and how they can overcome them in the workplace.
Overcoming barriers (breaking into new disciplines, verticals, industries) - Work with a mentee who’s looking to break into a new discipline but doesn’t know where to start. Talk through the process of entering a new venture, and help them understand or explore what barriers might be faced along the way.
Skill development - Is there a specific skill set you’ve developed that you think you can help a mentee work on as well? Let us know and work with a mentee who could use your guidance.
Other
Select All
If you selected other above please elaborate here:
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