SHE Leads!™ Class of 2023 Champion (Mentor) Application
Throughout this application we ask questions to get to know you and understand what leadership and fundraising experience you have. We will also use this information to determine your best mentee match.
NOTE: As we are a non-profit organization we ask for specific demographic information, marked with +. The information is gathered and provided or aggregated to granting organizations to demonstrate our efforts to be an inclusive organization. We do not share or sell your information.
I. Tell Us About Yourself
Full Name
*
First Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work Address (if different from home address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Phone Number
*
Format: (000) 000-0000.
Work Phone Number
*
Format: (000) 000-0000.
Personal Email Address
*
example@example.com
Work Email Address
*
example@example.com
Which email do you prefer us to use to communicate with you - SHE Leads! announcements, calendar invitations, etc.......?
Type option 1
Type option 2
Type option 3
Type option 4
*Birthdate
*
-
Month
-
Day
Year
If you are not comfortable sharing your birth year, please enter the year "1900"
*Age Range
*
25-34
35-44
45-54
55-64
65-74
75+
*Are you of Hispanic, Latino, or of Spanish origin? (ethnicity)
*
Yes
No
If yes, please specify below:
*Race
*
Asian or Asian American
American Indian or Alaska Native
Black or African American
Middle East or North African
Native Hawaiian or Other Pacific Islander
White
Prefer Not Disclose
Other
If you selected "Other" please specify below:
What are some of your favorite hobbies or activities?
Employer/ Company Name
*
Approximate Size of Company
*
You best estimation of how many employees are at your current company.
Position/ Title
*
Number of Years at Your Current Position
*
Current Industry
*
Number of Years in Current Industry
*
Do you own your own business or are you self-employed?
*
Own Business
Self Employed
Not Applicable
Do you work for a non-profit organization or a for profit company?
*
For Profit
Non-Profit
Is your current industry female or male dominated?
*
Female Dominated
Male Dominated
Equal
What is your current salary range?
*
Under $15,000
$15,000 - $24,999
$25,000 - $34,999
$35,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 - $149,999
$150,000 - $199,999
$200,000 and Over
Retired
Do you lead people in your current position?
*
Yes
No
Have led in the past
If applicable, how many years of leadership experience do you have?
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II. How Did You Learn About Us?
How did you hear about the SHE Leads!™ program?
*
Please Select
SHE Leads! Alumni
LinkedIn
Facebook
Instagram
AFW Website
AFW Newsletter
Employer
Word of Mouth
Other
If you selected "Other" above, please include the source below
If you were referred to apply by someone, please enter their name below
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III. Please include your LinkedIn Profile Link, Resume and Headshot
LinkedIn Profile Link
*
Additional Social Media Links
Upload Your Resume
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload Your Most Up to Date Professional Headshot
*
Browse Files
Drag and drop files here
Choose a file
This photo will be used for program press release, if selected as a Champion.
Cancel
of
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IV. Your Experience
Please describe in detail as you answer these questions
1. Please provide information about your leadership experience that you believe would be relevant to the application (i.e. past positions, years, number of subordinates, etc.)
*
2. Why would you like to be a Champion (Mentor) for the SHE Leads!™ program?
*
3. Have you ever been a mentor before (informally or in a program)? If yes, please describe your experience.
*
4. Class participants have a fundraising requirement. Do you have any experience with fundraising? (This experience is not required in order to be selected)
*
Yes
No
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V. Your Commitment
I have reviewed the SHE Leads! program and understand the Champion (Mentor) requirements and expectations.
*
If selected, I am available to attend the required program orientation session on October 20, 2022 from 6:00-7:30 pm.
*
If selected, I am available to attend the required Champion/Participant pairing event on December 15, 2022 from 6:00 – 7:30 pm.
*
If selected, I understand that I will need to sign a confidentiality agreement in order to participate as a Champion (Mentor).
*
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