2025 YP IMPACT Mentorship Program

2025 Mentee Application

By completing this form, you are expressing interest in being a mentee as part of the 2025 IMPACT Mentorship Program.
First & Last Name*

First NameLast Name
Company/Organization Name*
Position/Title*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
LinkedIn URL (Optional)
example@example.com
What is you background? Use this section to briefly describe your personal, professional, leadership, and philanthropy background.*

What are 3 goals would you like to get out of this mentorship program?*

	Please list 3 personal or professional goals
Goal #1
Goal #2
Goal #3

Areas of Interest, check all that apply.*

Accounting/FinanceArts, Entertainment & MusicBusiness Management/Small Business FormationCommunity Involvement/PhilanthropyGovernment Affairs/Public PolicyHuman Resources/Talent AcquisitionsLeadershipPublic Relations/MarketingSalesOther
Industry Experience, select all industries you have experience in.*

BankingEducationFinancialGeneral BusinessGovernmenthealth & WellnessHospitalityInsuranceMusic, Arts & EntertainmentNonprofitProfessional ServicesRetailSales & MarketingTechnologyManufacturingEngineeringLegalOther
What methods of contact do you prefer?*

EmailPhone CallText MessageVideo Call
Would you see additional value in being mentored by a male or female? (please choose)*

MaleFemaleNo PreferenceOther
Will you be able to attend the required Mentee 101 session on February 14 at about 10:30 am (following the Jabber and Java event)?*

YesNo
Do you agree to abide by the requirements outlined by the YP Mentor Program and commit at the minimum of one with my mentor per quarter and the mix and mingle event in November?*

YesNo
Should be Empty:

2025 Mentee Application