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What is the most interesting class you have ever taken?
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In which of the following industries do you have knowledge or experience?
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6-15 years
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Name of Company
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Address
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Canada
France
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India
Brazil
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Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Democratic Republic of the Congo
Republic of the Congo
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
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Myanmar
Namibia
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Nepal
Netherlands
Curacao
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
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Have you ever participated in a mentoring program?
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Please list the programs.
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What special skills / experiences do you have that might be valuable to share with a mentee:
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List three strengths.
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Do you speak any languages other than English? If yes, please list.:
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Which mentee age range do you prefer?
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High School (16-17)
College (18-22)
Young Professional, (22+)
No Preference
Please list any preferences you have regarding a mentee (e.g. major, demographic, interests, background, etc.)
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What are your hobbies and interests?
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In 140 characters or less, tell us about yourself.
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Do you participate in any extracurricular activities outside of school? (e.g. Girl Scouts, youth programs)?
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Finish this sentence: If I could be anything in the world, I would be...
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What is your career goal or what types of careers interest you?
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What does being a Fairy Godsister mean to you, and why do you want to be one?
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Why do you want a Fairy Godsister?
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Please list any preferences you have regarding a mentor (e.g. major, demographic, interests, background, etc.)
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Please provide name, telephone number, and email of three references - at least one of which is professional.
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Have you ever been convicted of a crime?
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If so, please explain.
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Is there anything else you would like us to know?
How did you hear about us?
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