Mentor Application Form

NWIIWA Mentorship Program – Mentor Overview

The NWIIWA Mentorship Program is designed to cultivate meaningful, mentee-driven relationships that support personal and professional growth.

As a mentor, your role is not to lead or manage, but to serve as a trusted guide, resource, and supporter — helping your mentee navigate their journey with insight, empathy, and encouragement.

What’s Expected of You

Four 1-hour mentoring sessions, scheduled at your mutual convenience
(In-person or virtual — whatever works best for both of you)

Attend the in-person Kickoff Event to meet your mentee and connect with other program participants.

That’s it! The structure is intentionally simple to respect your time, while still offering an impactful experience.

How You’ll Make a Difference
Through your involvement, you’ll help your mentee:

Build Skills: Support the development of leadership and professional strengths
Gain Guidance: Offer thoughtful feedback and real-world insights
Clarify Career Goals: Encourage strategic thinking and planning
Expand Networks: Open doors to broader connections and industry perspectives

Important Reminders

The mentee leads the relationship. They’ll set goals, schedule meetings, and follow up. Your role is to listen actively, encourage growth, and share wisdom when appropriate — not to “fix” or take charge. Consistent check-ins and honest dialogue go a long way in creating an impactful experience.

Support Along the Way
NWIIWA and the Mentoring Committee will provide helpful tools, professional development opportunities, and continued guidance throughout the program and check in with you.

We’re here to ensure that you feel supported and appreciated every step of the way.

Final Thought

We invite you to approach this opportunity with purpose, empathy, and a spirit of encouragement. Your presence alone makes a difference — and your influence has the power to spark lasting change in someone’s journey.

Thank you for being part of this experience.

Name*

First NameLast Name

Date*

Date

Email*

example@example.com

Title*

Company*

Title*

Phone Number*

Format: (000) 000-0000.

Are you a NWIIWA Member*

YesNo

Briefly describe your professional background and areas of expertise.*

What industries or sectors do you have experience in? (List all that apply.)*

How many years of professional experience do you have?*

0-5 Years6-10 Years11-20 Years20+ Years

Have you previously served as a mentor (formally or informally)?*

YesNo

If yes, briefly describe your mentoring experience.*

What professional skills or topics are you most comfortable mentoring someone in?*

Why are you interested in serving as a mentor in the NWIIWA Mentoring Program?*

Are there particular areas you would prefer NOT to mentor in?*

How would you describe your communication style?*

How do you prefer to meet with your mentee? (Check all that apply.)*

In-PersonVirtualEither

Are you willing to attend the required program events (Kickoff, Professional Development Sessions, and Celebration)?*

YesNo

Are you okay matching with a mentee outside of your industry?*

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.

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. Do you agree to this?*

YesNo

If selected, do you agree to actively engage with your mentee and uphold the NWIIWA Mentoring Program Code of Conduct?*

YesNo

Would you like to be considered for future co-horts?*

YesNo

What do you personally hope to gain from serving as a mentor?

Is there anything else you'd like us to know about you as we match mentors and mentees?*

NWIIWA Mentor Application