Fillable Faculty Mentoring Program Protege Application

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Faculty Mentoring Program Protege Application

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The Faculty Mentoring Program Protege Application form is 2 pages long and contains:

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Country of origin: US
File type: PDF

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Faculty Mentoring Program Protégé Application
Protégé Information
Last Name First Name
Title:
Department:
Manager:
Desk Phone: Email:
Fresno State ID #:
Statement of Interest. Briefly describe why you would like to participate in the Mentoring
Program and what leadership skills you are most interested in developing.
What are you looking for in a mentor?
List your long term goals.
List your short term goals.
Program Conditions
1. While participation is voluntary, a two-year commitment is expected of participants. Year 1 will
include more formal programs; Year 2 less will be less frequent and less formal.
2. Mentor and protégé pairs will meet monthly at a site to be determined by the mentoring pairs.
3. Mentors and protégés are expected to make bi-weekly contacts at a minimum (Year 1).
May be in person, via telephone or other means of communication.
Applicant Signature Date: _____________
Applicant Name (Printed) _________________________________
Both the applicant and I believe she/he will benefit from the Faculty Mentor Program. We understand
the time commitment necessary.
Dean Signature Date: ___________
Dean Name (Printed) __________________________
Department Chair Signature Date: ___________
Department Chair Name (Printed) __________________________
Applicants should submit this form to: Kathleen Scott to M/S ML 52 or email to kscott@csufresno.edu
by Monday, September 21, 2015.
Questions? Please call (559) 278-5330
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Faculty Mentoring Program Protege Application

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Completed 24 April 2020

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