WI Roundtable Program Application

Mentoring & Roundtables Program Application

The mission of the Women's Initiative is to provide opportunities for women of all career stages to Connect, Grow, and Achieve in business. Women's Initiative provides the Mentoring and Roundtables programs as a benefit to all female Chamber members.
Name: *
Preferred Email:*
example@example.com
Preferred Phone Number:*
Company Name:*
Must be a current NKY Chamber member to participate
Job Title: *
Industry:*
Age Range:

20-3030-4040-5050-6060+
Racial Identity:

American Indian or Alaskan NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Pacific IslanderWhite or CaucasianOther
Current Career Level:*

EntryMiddle ManagerSenior ManagerC-Suite, Executive Director, VPSelf-Employed/Small Business Owner
Select all that you are applying for:*

Becoming a MenteeBecoming a MentorParticipating in the Roundtables program
Mentoring Program:
The purpose of the Women's Initiative Mentoring program is to enable a pair to meet for a one-on-one relationship for career growth over the period of one year. Participating in this program will help the pair to grow as leaders in their organizations.

Roundtables Program:
The purpose of the Women's Initiative Roundtables program is to promote the professional development of women. The Roundtables program is a confidential and collaborative group setting that provides support through shared professional knowledge and experiences. Roundtables are comprised of 6-8 individuals from varying career stages and industries.
What are your professional areas of interest?*
What do you hope to achieve from participating in this program?*
Do you have any professional or personal barriers that you have overcome that would be helpful in matching you with a mentor/mentee/roundtable?*
What types of activities, in addition to monthly meetings, would you find beneficial (e.g., attendance at networking events, board meetings, political functions, cultural events, etc.)?*
Do you have any additional information for the selection committee?
Women’s Initiative Program Confidentiality Agreement*

As a participant of a Northern Kentucky Chamber of Commerce Women’s Initiative program, I agree to keep all table discussions confidential. I will not discuss the content from meetings, nor will I disclose the content of discussions relating to other participants of organizations represented in the program. And, to maintain the integrity of the program, I agree to provide appropriate feedback to fellow participants. Should a conflict with my table and/or mentoring match, I agree to disclose this information to the program the appointed NKY Chamber representative immediately.
Questions regarding the form or the programs? Contact the Director of Women’s Initiative, Holly Nibert: hnibert@nkychamber.com

Participation in the Mentoring and/or Roundtables program is a Chamber member benefit. To see if your company is a current member, CLICK HERE.
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Mentoring & Roundtables Program Application