Mentorship Registration
Complete the form below to sign up for our mentorship service.
Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Preferred way to contact
*
Phone
Email
Any
Where did you hear about us?
A Friend or colleauge
Social Media
Previous Client
Other
Mentee Questionnaire
Please answer all questions to your best ability.
Are you currently a buisness owner?
*
Yes
No
If so, what is(are) your business avenue(s)?
How do you stay competitive in your industry?
Where do you ultimately want to end up in your career (role, title, income, etc.)?
*
What inspired you to want to pursue this work?
*
If you could learn any new professional skill (it doesn’t have to be related to your current role or industry), what would it be?
*
What are your short-term goals?What are your long-term goals?
*
What is the motivation behind your goals? Why are they important to you?
*
Do you have any habits that hinder your success?
*
How often do you check-in with yourself about your thoughts, feelings, and actions?
How committed are you to change?
scale 1-10
Mentorship Availability & Expectations
What days of the week are best for mentoring?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Wha time(s) are the best for mentoring?
*
Morning
Afternoon
Either
Do you perfer in person meetings or video chat meetings?
*
In Person
Video Chat
Either
What are you looking to get out of your mentorship with Keyona Squire?
*
Have you had a mentor in the past? What was that experience like for you?
*
Submit Application
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