Mentor Application Assessment

Mentor Application Assessment

In order for us to better fit you with the appropriate Protégé, please provide the following information:
Name

First NameLast Name
Email
example@example.com
Have you ever been in a Protégé/Mentor relationship/program?

NoYes, but it was an informal relationshipYes, but it was in a formal program
If you selected "formal program" in the question above, tell us more:
If you have been in a Protégé/Mentor relationship/program in the past, what did you find valuable? What wasn’t valuable about the relationship/program?
What do you plan to achieve as a result of this program? Please include professional, academic, personal, leadership, extracurricular, and any other goals you plan to accomplish via this program.
Do you want to be matched with someone within your field of security?

Yes, I would like to be matched with a Protégé from my field of security.No, I would like to be matched with someone from a different field of security.I do not care if the Protégé is in my field or in a different field of security.
What is your primary area of expertise within the security industry?
What other areas within the security industry would you feel comfortable providing mentoring and guidance.
Would you be willing to mentor for specific certification domains? You may select more than one, if applicable.

CPPPSPPCIAPP
Topics you would be willing to mentor.
What is your highest professional experience?

Entry Level Manager (1-10 employees, one program)Mid-Level Manager (10-20 employees, several programs)Advanced Level Manager (20+ employees, multiple programs & sites)Program ManagerDirector, Senior Director, Executive DirectorVice President, Senior V.P., Executive V.P.PresidentCEO / COOCSO, Corporate Director ConsultantOther
Select all areas below you would feel comfortable proving mentoring assistance with to a Protégé?

On-going career developmentUsed to solve a long-term projectSkill improvementCompany/Industry cultural comprehensionEducational foundation expansionBroader quality performanceEnhance/Increase professional visibilityPractice strategiesNetworkingArea specialty development and practiceGuidance on job searchesResume critiquesMock interviewsInformational interviewsProject collaboration and/or critiqueOther
What mechanisms of communication do you have available to you to interact with your Protégé? Supply information on those you wish to use.

Business PhoneCell PhoneBusiness e-mailPersonal e-mailGo-to-meeting capabilitiesLive chatVideo conferencingFace-to-face meetingsOther
Are you willing to provide both verbal and written feedback to the Protégé and/or the Protégé’s manager (if the Protégé requests manager’s inclusion into the program)?

Yes, I am willing to provide both verbal and written feedback to the Protégé.I am willing to provide only verbal feedback to the Protégé.I am willing to provide only written feedback to the Protégé.I am willing to provide verbal and written feedback to the Protégé’s manager, if requested by the Protégé.I am willing to provide only verbal feedback to the Protégé’s manager, if requested by the ProtégéI am willing to provide only written feedback to the Protégé’s manager, if requested by the Protégé.No, I am not willing to provide feedback to the Protégé’s manager. I wish to work with the Protégé exclusively.
Should be Empty: