Bespoke Mentorship Program Round Five Application
Name
*
First Name
Last Name
E-mail
*
example@example.com
Are you a member of AMPIA? Please be aware, only AMPIA members will be considered for the program. Non-members can sign up at ampia.org.
Yes
No
Do you identify as IBPOC?
Yes
No
Would Rather Not Say
Please provide a brief biography, resume or company profile highlighting key achievements and experiences or upload a file.
File Upload - Biography, Resume or Company Profile (Optional)
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of
Please specify the skills you aim to develop through this program, and how it will benefit your professional goals long term.
Please provide a brief description of the project you're working on.
Please provide a detailed timeline specifying measurable goals and deliverables.
Please provide a list of 2-3 producers you'd like to work with as part of the program and why.
What about you and your skillset is unique? What are your strengths going into this program?
File Upload - Additional Files (Optional)
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