2024-25 Mentoring Program Protégé Application

Mentoring Program Protege Application

2024-25
Mentoring Program Protégé Criteria:
- You must be a Tempe Chamber of Commerce member in good standing
- Have at least 2+ years of work experience
- Make a commitment to the 6-month program with regular monthly organized sessions and additional independent meetings between mentors and protégés
- If not self-employed, obtain an employer’s commitment to participate in the program
- Be open to self-assessment, self-discovery, and the life coach experience and enrichment
- The fee for protégés is $100 to be paid by October 4, 2024.
Mentoring Program Timeline
- Completed applications must be received by Friday, September 13, 2024.
- Selected applicants may be interviewed for consideration
- Pairings will be announced the Week of September 23rd.
Mentor Program workshop dates are:
Friday 10/11/2024 9:00 - 11:30 am
Friday 11/8/2024 9:00 - 11:30 am
Friday 12/13/2024 9:00 - 11:30 am
Friday 1/10/2025 9:00 - 11:30 am

Friday 2/14/2025 9:00 - 11:30 am
Friday 3/14/2025 9:00 - 11:30 am

Graduation Ceremony at the Leadership Conference on Friday, April 11, 2025.

The application must be completed in its entirety in order to be considered. If you are working for an employer, an agreement will be sent following this application for an employer to sign.

To assist in your conversation with your employer about this program, please download this helpful Mentoring Program Overview.
PROTEGE CONTACT INFORMATION
Name*

First NameLast Name
Company Name*
Your Title*
Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Work Phone Number*

Area CodePhone Number
Mobile Phone Number*

Area CodePhone Number
Supervisor's Name (if applicable)

First NameLast Name
Supervisor's Phone Number

Area CodePhone Number

PREVIOUS EMPLOYMENT

Please supply two previous employers
Employer*
TItle*
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
Employer*
TItle*
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
EDUCATIONAL HISTORY

List type of degree, major and name of school
High School*
Bachelors/Major
Masters/Major
Doctorate/Major
Professional Certifications/Designations
REFERENCES

List two business professionals who will be contacted to provide information regarding your qualifications as a Mentoring Program participant. If you are not self-employed, please include your supervisor as one of your references.
Reference 1*

First NameLast Name
Company Name*
Title*
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Reference 2*

First NameLast Name
Company Name*
Title*
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
What format do you prefer for mentoring one-on-one meetings?

VirtualIn personEither option is fine with meOther

PROTÉGÉ PROFILE
Describe your current role & responsibilities.*
What do you envision as your next job or career step?*
Describe your personal and professional goals.*
Describe any professional development you have been involved in within the past year. (conferences, webinars, books, etc.)*
Describe the skills you would like to develop or improve.*
Describe your ideal mentor and/or what specific industry or profession you'd like to be paired with.*
What do you hope to gain from participating in the Mentoring Program? *

TUITION FEES

The cost to participate in the Tempe Chamber Mentoring Program is $100. Tuition fees will support the program, include your materials, and registration to the Leadership Conference in Tempe on Friday, April 11, 2025.
Who will cover the tuition for this program?*

Your Employer/BusinessYourself (individual/sole proprietor)
If partial scholarship opportunities are available, would you be interested?

YesNo
MENTORING PROGRAM AGREEMENT OF UNDERSTANDING

I authorize the Tempe Chamber of Commerce to contact the listed references and my current employer. The Mentoring Program may also release, if necessary, information contained in this application. I have read and understood the program commitment and am willing to honor that commitment.
Applicant Signature*

Clear
If you work for a business/employer, we will require an Agreement of Understanding to be signed prior to your acceptance to this program. This Agreement will state that the employer understands the time commitment and that they agree to provide the applicant with the time away from the workplace to attend all scheduled activities.
Applications must be submitted by Friday, September 13, 2024. Any questions or concerns regarding this application can be sent to karin@tempechamber.org.
Should be Empty:

Mentoring Program Protege Application

PROTEGE CONTACT INFORMATION

PREVIOUS EMPLOYMENT

EDUCATIONAL HISTORY

REFERENCES

PROTÉGÉ PROFILE

TUITION FEES

MENTORING PROGRAM AGREEMENT OF UNDERSTANDING