2024-25 WIB Mentoring Program Mentor Application

Mentoring Program Mentor Application

2024-25
Mentoring Program Mentor Criteria:
- You must be a Tempe Chamber of Commerce member in good standing
- Have at least 5 years of business experience and 2 years of leadership experience
- Have been in your current position for at least 6 months
- 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
- Mentors are responsible for the cost of their ticket to attend the Leadership Conference on Friday, April 11, 2025.
Mentoring Program Timeline
- Completed applications must be received by Friday, September 13, 2024
- Selected applicants may be interviewed for consideration
- 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
- Pairings will be announced the Week of September 23rd.
- Graduation Ceremony at the Leadership Conference on April 11, 2025.
The application must be completed in its entirety in order to be considered.

To assist in your conversation with your employer about this program, please download this helpful Mentoring Program Overview.
MENTOR 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
Have you participated in the Tempe Chamber Mentoring Program in the past?

Yes, as a protegeYes, as a mentorNo, I have not participated in the past

PREVIOUS EMPLOYMENT

Please supply two previous employers
Employer*
TItle*
Employer*
TItle*
EDUCATIONAL HISTORY

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

Please provide a reference for an individual you have mentored or has worked for you in your leadership position in the past several years.
Reference Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number

MENTOR PROFILE
Describe your current role & responsibilities.*
Describe your personal and professional accomplishments.*
Describe any professional development you have been involved in within the past two years. (conferences, webinars, books, etc.)*
Describe the leadership skills you would like to share through this program.*
Describe your ideal protege and/or what specific industry or profession you'd like to be paired with.*
What do you hope to gain from participating in the Tempe Chamber Mentoring Program? *

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, the information contained in this application. I have read and understood the program commitment and am willing to honor that commitment.

I agree to have at least one phone or face-to-face meeting with my protege each month of this program.

I agree that I am responsible for the cost of my ticket to attend the Leadership Conference on Friday, April 11, 2025.
Applicant Signature*

Clear
Applications must be submitted by Friday, September 13, 2024. Any questions or concerns regarding this application can be sent to karin@tempechamber.org.
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Mentoring Program Mentor Application

MENTOR CONTACT INFORMATION

PREVIOUS EMPLOYMENT

EDUCATIONAL HISTORY

REFERENCES

MENTOR PROFILE

MENTORING PROGRAM AGREEMENT OF UNDERSTANDING