Learning to Leadership™ Student Success Academy Professional Mentor Application A Signature Initiative of Green Kingston Group LLC Estimated Completion Time: 10–15 minutes
Welcome! Help Shape the Next Generation of Leaders. Thank you for your interest in becoming a Learning to Leadership™ Professional Mentor. Learning to Leadership™ Student Success Academy connects students with accomplished professionals who are passionate about helping young people discover their purpose, develop their potential, and lead their future.Our students may be located in the United States, Liberia, and other countries where Learning to Leadership™ partners with schools and educational organizations. Mentoring relationships are conducted primarily through virtual meetings, creating meaningful opportunities for students and mentors to learn from one another across cultures and borders. Professional Mentors serve as trusted role models by providing encouragement, accountability, career insight, and guidance as students prepare for college, careers, and life.Please complete the application below. We look forward to learning more about you.Required fields are marked with an asterisk (*).
Personal Information
Name
First Name
Last Name
Preferred Name
Email
example@example.com
Mobile Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
WhatsApp Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
LinkedIn Profile
Professional Website (optional)
Professional Information
Current Job Title
Organization/Employer
Industry
Please Select
Education
Business
Entrepreneurship
Healthcare
Medicine
Engineering
Technology
Law
Finance
Government
Public Service
Architecture
Media & Communications
Marketing
Arts & Culture
Nonprofit Leadership
Science & Research
Skilled Trades
Other
Years of Professional Experience
0-5 years
6-10 years
11-15 years
16-20 years
More than 20 years
Please provide a brief professional biography.
Mentoring Interests
Which students would you feel most comfortable mentoring?
Grade 10
Grade 11
Grade 12
Current College Students
No Preference
Are you comfortable mentoring students who may reside outside of your country?
Yes
No
I'd like more information
Which students would you be interested in mentoring?
Students in the United States
Students in Liberia
Students in other African countries
No preference
Which areas would you be comfortable mentoring students in? (Check all that apply)
Academic Success
Leadership Development
College Readiness
Career Exploration
Goal Setting
Time Management
Professional Etiquette
Résumé development
Interview Preparation
Entrepreneurship
Networking
Workplace readiness
General Life Skills
Other
What academic majors, career fields, or student interests do you feel most prepared to mentor?
Why are you interested in becoming a Learning to Leadership™ Professional Mentor?
Back
Next
Availability
How often are you available to meet with a student?
Weekly
Every Two Weeks
Monthly
Flexible
Preferred Meeting Format
Virtual
In-Person (when available)
Either
If mentoring students internationally, what times generally work best?
Morning
Afternoon
Evening
Flexible
Preferred Days
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Mentoring Experience
Have you previously served as a mentor?
Yes
No
If yes, please describe your mentoring experience.
Have you ever lived, studied, volunteered, or worked outside your home country?
Yes
No
If yes, please describe your experience.
Professional Expertise
Which topics could you confidently discuss with students?(Check all that apply.)
College Readiness
Career Planning
Leadership
Business
STEM
Healthcare
Engineering
Education
Finance
Law
Public Speaking
Networking
Professional Branding
Workplace Readiness
Communication Skills
Graduate School
Study Abroad
Entrepreneurship
Other
What qualities do you believe are most important when mentoring students from diverse cultural backgrounds?
Do you speak any languages other than English? (Check all that apply.)
English
French
Spanish
Arabic
Portuguese
Other
References
Professional Reference #1
Name
*
First Name
Last Name
Organization
*
Job Title
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to You
*
Professional Reference #2 (Optional)
Name
*
First Name
Last Name
Organization
*
Job Title
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to You
*
Additional Information
Is there anything that you would like us to know?
How did you hear about Learning to Leadership™?
Green Kingston Group Website
Social Media
Colleague
Friend
School Partner
Professional Organization
Conference/Event
Other
Acknowledgements
Please review each statement below
I certify that the information provided is accurate to the best of my knowledge.
I understand that submitting this application does not guarantee selection as a Professional Mentor.
I understand that mentors are selected based on experience, availability, program needs, and alignment with Learning to Leadership™'s mission.
I understand that I may be matched with a student residing in another country and that mentoring relationships may take place virtually across different time zones.
I understand that Learning to Leadership™ may request additional information or references before making mentor assignments.
I understand that, if required by program policy or partner schools, I may be asked to complete a background screening before working with students.
I agree to uphold the values of professionalism, respect, confidentiality, cultural awareness, and integrity while serving as a Professional Mentor.
Electronic Signature
Full Name
First Name
Last Name
Electronic Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Continue
Continue
Should be Empty: