IACAC Mentorship Application

Which option describes you best?*

New Counselor Mentee
This program is for a College Admission Counselor or High School Counselor that has been in his or her position for less than 3 years. This program will pair you with a mentor that can help guide you through your first few years.New Counselor Mentor
This program is for a College Admission Counselor or High School Counselor that has been in the profession for 3+ years and is looking to mentor a new counselor.Middle Management Mentee
This program is for a College Admission Counselor that has been in the profession for 3+ years and is looking to make the next move in his or her career, or has recently been promoted to a middle management position. In this program, you will receive guidance from veterans in their fields.Middle Management Mentor
This program is for members who have 3+ years of experience in middle management and would like to mentor an individual who is looking to move into management or who is new to the management role. This is a great opportunity to retain potential leaders in the counseling field.

Name*

FirstLast

Pronoun

Email*

Grad Student

I am a graduate student

Institution*

Grad School*

Internship Location

Mailing Address*

CityState

Zip

Work Phone*

Pair me with someone from:*

HS Type*

PublicPrivate

HS Region*

CPSNorthern IllinoisCentral IllinoisSouthern Illinois

2-Year College Region*

Northern IllinoisCentral IllinoisSouthern Illinois

4-Year College Type*

PublicPrivate

Rep Location*

Campus-BasedRegional Rep

Counselor Type*

Freshmen CounselorTransfer Counselor

4-Year College Region*

Northern IllinoisCentral IllinoisSouthern Illinois

Describe your institutional responsibilities:*

If you have a travel territory, list your counties or regions:

How many years of related experience do you have?

Tell us a little about your personality.*

Tell us a little more about your career goals and professional interests.*

What are you hoping to gain from having a mentor/mentee?*

What activities are you looking to get involved in?*

Tell us more about your professional experience. What can you offer a mentee?*

What experience do you have in ACAC’s?*

Special requests, i.e. looking for a Big 10 mentor or a POC? Maybe you’re looking for someone who didn’t start off working for their alma mater. Tell us anything that you’re specifically looking for in a mentor/mentee here. We cannot guarantee that we will have someone who fits this mold, but we will do our best!*

How did you hear about the Mentorship Program?*

Is there a question that you would like IACAC to answer for you?*

Birth Date

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