Mentor ~ Mentee Matching Form
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Language Proficiencies
*
Your Hobbies and Interests
*
Visual Arts
Electronic Games
Shopping
Music
Volunteering
Politics
Reading
Sports/Exercising
Writing
Gardening
Other
What Best Describes you
*
Outgoing
Business-oriented
Constructive
Empathetic
Funny
Lively
Intuitive
Passionate
Reserved
Reflective
Vibrant
Other
Professional Interest or Expertise
*
Arts and Entertainment
Business and Development
Consultancy
Education
Engineering
Financial Services
Health Care and Medicine
Information Technology
Legal and Litigation
Marketing and Advertising
Non-Profit Administration
Decor
Politics
Publishing
Science and Technology
Music Industry
Crafting
Other
The role you would like your Mentor to play:
*
Colleague/Networking
Listener
Motivator/Accountability Partner
Career Development
Life Mentor
Other
Areas where you hope your mentor to make impact
*
Knowledge and Practice of Professional Etiquette
Focus and practice on the Field of Career
Professional Network Expansion
Personality Development
Communication Skills Improvement
Have you had mentoring before?
*
Yes
No
Would you prefer:
*
Group Setting
One on One
Your Preference of Communication with your Mentor
*
email
text
phone
In person
Zoom
How often would you like mentorship?
*
Weekly
Bi-Weekly
Every 3 weeks
Monthly
When would you like to begin your mentorship?
*
Your Personal Information
Tell me something about yourself
*
Where do you see yourself in five years?
What are your expectations in this Mentoring program?
Appointment
Date
-
Month
-
Day
Year
Date
My Products
prev
next
( X )
Good Fit Consultation Fee (Nonrefundable)
10-15 minute consult
$25.00
$
25.00
Submit
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