EMERGE Mentorship Program Application

EMERGE Mentorship Program Application
The EMERGE Lakeland Mentorship Program is a six-month mentoring experience connecting EMERGE Lakeland members with business and community mentors. The program runs rom January through June 2027.

Selected participants are expected to:
- Attend the January Kickoff Event
- Meet with their mentor at least once each month
- Attend the March Midpoint Event
- Attend the June Closing Celebration
Do you commit to these expectations and dates?
How many hours each month do you anticipate dedicating to this experience?
Does your supervisor or employer approve this commitment?
1. Your Information
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Company or Organization
Current Job Title
How many years of professional experience do you have?
How many years have you lived (or worked) in Lakeland?
Why are you applying to have a mentor through EMERGE Lakeland?
What are you hoping to gain from this experience?
If you had one Saturday free – with no responsibilities – what could you lose time doing?
2. Goals
Looking ahead through the next five years, what do you hope will change in your career?
What's one challenge you're currently working through?
Choose up to three (3) of these topics that are relevant to your urrent career journey of reason for seeking a mentor:
How would you describe your current volunteer self? (select all that apply)
Final Questions
What does having a mentor mean to you?
Is there anything else you'd like the Program Committee to know about you as they consider your application?
Please upload a current resume

Browse Files

Cancelof
Please upload a current headshot

Browse Files

Cancelof
Should be Empty:

EMERGE Mentorship Program Application

1. Your Information

2. Goals

Final Questions