2025-26 Mentoring Program Mentor Application

Mentoring Program Mentor Application

2025-26
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.
- You have been in your current position for at least six months to a year.
- Make a commitment to the 6-month program with regular monthly organized sessions and additional independent meetings between mentors and protégés.
- The Tri Metrix assessment will be administered as part of the Mentoring program. Completing the assessment before the first meeting is essential.
- The application must be completed in its entirety in order to be considered.
Mentoring Program Timeline
- Completed applications must be received by Monday, September 22, 2025
- Selected applicants may be interviewed for consideration
- Mentor Program workshop dates are:
  - Friday 10/10/2025 9:00 - 11:30 am
  - Friday 11/14/2025 9:00 - 11:30 am
  - Friday 12/12/2025 9:00 - 11:30 am
  - Friday 1/9/2026 9:00 - 11:30 am
  - Friday 2/6/2026 9:00 - 11:30 am
  - Friday 3/13/2026 9:00 - 11:30 am
- Pairings will be announced the Week of September 22nd.
- Graduation Ceremony at the Leadership Conference on April 10,2026.
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 visit the Mentoring Program overview: HERE.
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 the leadership skills you would like to share in 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 Mentoring Program? *
Share a fun fact.*

MENTORING PROGRAM AGREEMENT OF UNDERSTANDING
Upload high-quality headshot *

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By signing this, I agree to have at least one phone or face-to-face meeting with my protégé each month of this program. I confirm that 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 it.
Applicant Signature*

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Mentoring Program Mentor Application

MENTOR CONTACT INFORMATION

PREVIOUS EMPLOYMENT

EDUCATIONAL HISTORY

REFERENCES

MENTOR PROFILE

MENTORING PROGRAM AGREEMENT OF UNDERSTANDING