Mentee Application Form

The NWIIWA Mentorship Program is a mentee-driven initiative designed to empower participants to take ownership of their personal and professional growth.

Your success in this program will largely depend on your commitment, initiative, and engagement with your mentor.

What is included:

Clifton Strengths Assessment
Kick-Off Celebration with all Mentors, Mentees and Committee Members
Four 1-Hour Mentoring Sessions
Professional Development Program – 1 Ticket
Professional Women’s Conference – 1 Full Admission Ticket
Graduation/Recognition Program at the Professional Women’s Conference

Cost of Participation

Program value: $475
NWIIWA Grant: $400
Your total cost: $75

*Full payment will be collected after mentor pairing is confirmed.

What You’ll Gain:
Build Skills-Develop leadership capabilities and gain real-world professional insight.
Gain Guidance- Receive coaching, encouragement, and actionable feedback from a seasoned mentor.
Clarify Career Goals-Define your aspirations, set meaningful goals, and create momentum for your career.
Expand Your Network-Form lasting connections with fellow professionals across the region.

Please Note
Mentees are responsible for setting goals, initiating meetings, and following through on action items.

Mentors serve as guides and supporters — not drivers of the relationship.
The more effort, honesty, and communication you invest, the more meaningful your experience will be.

NWIIWA and the Mentorship Committee are here to offer tools, encouragement, and guidance — but ultimately, the growth you experience is in your hands.

We encourage you to approach this journey with purpose, curiosity, and an open mind.

Your development starts here — and it starts with you.

Name*

First NameLast Name

Date*

Date

Email*

example@example.com

Company*

Title*

Phone Number*

Are you a NWIIWA Member?*

YesNo

Briefly describe your current position. *

What areas of professional development are you most interested in?*

What are your short-term career goals (next 1-2 years)?*

Why are you seeking a mentor? (Check all that apply.)*

Are you confident that you will have time in your schedule to commit to regular mentorship meetings for the duration of the program? *

YesNo

Can you attend mentorship program events (virtual and/or in person) during or after working hours?*

YesNo

Matching Process

Mentors and mentees will be thoughtfully paired based on:

Professional experience and industry alignment-If applicable
Career interests and growth goals
Communication and engagement preferences.

Disclaimer:

Please note that submission of a mentor (or mentee) application does not guarantee placement in the current cohort. Pairings are made thoughtfully based on alignment of interests, goals, and availability to ensure the most impactful experience for all participants. If a suitable match is not available at this time, your application will be kept on file and considered for future cohorts.

I Agree

Do you agree to fill out a monthly mentee check in form?*

I Agree

Are you involved in any community or professional organizations?*

Please share any potential barriers to participation that we should be aware of.*

Is there anything else we should know to better match you with a mentor?*

How do you prefer to communicate with your mentor? (Select all that apply.)*

NWIIWA Mentee Application