Mentor Application Assessment
In order for us to better fit you with the appropriate Protégé, please provide the following information:
Name
First Name
Last Name
Email
example@example.com
Have you ever been in a Protégé/Mentor relationship/program?
No
Yes, but it was an informal relationship
Yes, 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.
CPP
PSP
PCI
APP
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 Manager
Director, Senior Director, Executive Director
Vice President, Senior V.P., Executive V.P.
President
CEO / COO
CSO, Corporate Director Consultant
Other
Select all areas below you would feel comfortable proving mentoring assistance with to a Protégé?
On-going career development
Used to solve a long-term project
Skill improvement
Company/Industry cultural comprehension
Educational foundation expansion
Broader quality performance
Enhance/Increase professional visibility
Practice strategies
Networking
Area specialty development and practice
Guidance on job searches
Resume critiques
Mock interviews
Informational interviews
Project collaboration and/or critique
Other
What mechanisms of communication do you have available to you to interact with your Protégé? Supply information on those you wish to use.
Business Phone
Cell Phone
Business e-mail
Personal e-mail
Go-to-meeting capabilities
Live chat
Video conferencing
Face-to-face meetings
Other
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 Protégé
I 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.
Submit
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