AMFP Mentee Application
Personal Information
First Name
*
Last Name
*
Email
*
example@example.com
Confirm Email
*
example@example.com
Phone
*
Format: (000) 000-0000.
Company
*
Tile/Role
*
Industry
*
Healthcare End User
Architecture/Design
Engineering
Construction
Other
Years of Experience in Field
0-5
5-10
10-15
15+
Tell Us About Yourself
Short Bio
*
Upload Photo
Browse Files
Drag and drop files here
Choose a file
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Have you been a mentor or mentee in the past?*
*
Yes, I have been mentored
Yes, I have been a mentor
This is my first experience
What is your biggest challenge or barrier that you need support to overcome?*
*
What do you expect to take away from your mentorship experience?*
*
Please share your top 5 values (1-5 in order of priority)*
*
What characteristics are most important to you for a mentor match?*
*
Tell us about your favorite hobbies or activities?*
*
Do you have any information you wish to share that would assist with a Mentor match?*
*
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LinkedIn
example https://www.linkedin.com/yourlinkedinaccount
Mentorship Commitment
Mentorship Eligibility
Mentorship Eligibility
Yes, I am an AMFP Tampa Bay Member
No, I am not an AMFP Tampa Bay Member
I am willing to attend 1:1 meetings with my mentor for one hour monthly, at a minimum.
Yes
No
I am available to commit to the Mentorship Program for the full duration (March-October 2025).
Yes
No
Mentors and Mentees Guidelines:
Mentor and Mentee will be contacted only once a match has been determined.
Mentor and Mentee will attend the mentorship kickoff in person in April.
Mentee and Mentor will be introduced via email with contact information and details within the application.
Mentee is responsible for connecting with the Mentor to coordinate meetings either via zoom, phone or in person.
Both parties will be asked to sign a letter of commitment and confidentiality agreement.
Mentee and Mentor agree to meet for a min of 1 hour once a month. The Mentee or Mentor decides if they wish to increase the frequency of meetings. This is at the discretion of both parties
Both parties will be asked to provide a testimonial and feedback at the end of the Mentorship period.
Do you agree to the Mentee/Mentor Guidelines?
Yes
No
Confirm Email*
*
example@example.com
Company*
*
Tile/Role*
*
Industry*
*
Healthcare End User
Architecture/Design
Engineering
Construction
Other
Years of Experience in Field
0-5
5-10
10-15
15+
Tell Us About Yourself
Short Bio*
*
Upload Photo*
*
Back
Next
Have you been a mentor or mentee in the past?*
*
Yes, I have been mentored
Yes, I have been a mentor
This is my first experience
What do you expect to take away from your mentorship experience?*
*
Describe what you consider to be your strongest general competencies (i .e ., knowledge, skills, and abilities):
Please share your top 5 values (1-5 in order of priority)*
*
What characteristics are most important to you for a mentee match?*
*
Tell us about your favorite hobbies or activities?*
*
Back
Next
Do you have any information you wish to share that would assist with a Mentee match?*
*
LinkedIn
example https://www.linkedin.com/yourlinkedinaccount
Mentorship Commitment
Mentorship Eligibility
Yes, I am an AMFP Tampa Bay Member
No, I am not an AMFP Tampa Bay Member
I am willing to attend 1:1 meetings with my mentor for one hour monthly, at a minimum.
Yes
No
I am available to commit to the Mentorship Program for the full duration (March-October 2025).
Yes
No
Mentors and Mentees Guidelines:
Mentor and Mentee will be contacted only once a match has been determined.
Mentor and Mentee will attend the mentorship kickoff in person in April.
Mentee and Mentor will be introduced via email with contact information and details within the application.
Mentee is responsible for connecting with the Mentor to coordinate meetings either via zoom, phone or in person.
Both parties will be asked to sign a letter of commitment and confidentiality agreement.
Mentee and Mentor agree to meet for a min of 1 hour once a month. The Mentee or Mentor decides if they wish to increase the frequency of meetings. This is at the discretion of both parties
Both parties will be asked to provide a testimonial and feedback at the end of the Mentorship period.
Do you agree to the Mentee/Mentor Guidelines?
Yes
No
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Submit
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