Fillable MentoringProgramApplication - MC App

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MentoringProgramApplication - MC App

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The MentoringProgramApplication - MC App form is 3 pages long and contains:

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File type: PDF

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Mentoring Program Application
Which position are you applying for?
MENTOR
☐
MENTEE
☐
Applicant Information
Full Name:
Gende
r
FEMALE
☐
MALE
☐
Last First M.I.
Phone:
Email
Preferred mode of communication?
In-person
☐
Text
☐
Email
☐
Current Position:
Department: Supervisor’s Name:
Length of
employment:
Choose an item.
Availability
During which hours are you available for meetings?
___ Weekday mornings ___ Weekend mornings
___ Weekday afternoons ___ Weekend afternoons
___ Weekday evenings ___ Weekend evenings
Personal Interests
What are some of your personal interests or hobbies?
What are some of your career goals? Please describe your short and long-term goals.
Mentoring Partnership
Why do you wish to participate in the mentoring program?
Rate the following desired benefits of mentoring from 1-5 according to how you value them. 1 being the
lowest and 5 being the highest.
FOR MENTEES FOR MENTORS
Learn how to balance work and life Foster inclusion
Expand knowledge of career path and
options
Enhance awareness of diversity issues
Develop interpersonal and communication
skills
Develop next generation of leaders
Expand knowledge of the campus Encourage organizational savvy
Gain knowledge of different career paths Share experiences and knowledge
Improve networking capability Provide an alternative source of feedback
to mentees
Develop teaming capabilities Enhance coaching skills
Improve job satisfaction and morale Utilize the wealth of professional expertise
and experience
What are some other desired outcomes you would like from this partnership?
Please describe what you expect from your ideal mentor/mentee?
Previous Experience
Summarize special skills and qualifications you have acquired from employment, previous volunteer work,
or through other activities, including hobbies or sports, which can positively contribute to a partnership.
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that
submitting an application does not guarantee a partnership.
Name (printed)
Signature
Date
Our Policy
It is the policy of this program to encourage and empower all employees seeking to accelerate their
careers as well as provide a climate of unity within the institution.
Thank you for completing this application form and for your interest in volunteering with us.
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MentoringProgramApplication - MC App

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Completed 15 November 2019

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