Women's Initiative Mentee Application

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.

Responsibilities
- One-year commitment to developing and maintaining a mentoring relationship with your mentor.
- Communicate with mentor on a monthly basis (at a minimum) to establish working relations.

Requirement
- Must be a female NKY Chamber member in good standing to participate as a mentee in the Women’s Initiative Mentoring program.

If you are not currently a NKY Chamber member, but would like more information, please contact Lynn Abeln at labeln@NKYChamber.com.

Fee
There is no fee to participate in this program. This is a NKY Chamber member benefit.

Questions
If you have any questions regarding the form or the program, contact Holly Nibert,Women’s Initiative, NKY Chamber of Commerce at hnibert@nkychamber.com or (859) 426-3651.

Name:*

First NameLast Name

Preferred Email:*

example@example.com

Preferred Phone Number:*

Area CodePhone Number

Job Title: *

Company Name:*

Company Address: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Industry:*

Highest level of education or professional credentials:*

Current Career Level:*

EntryMidExecutive or SeniorSelf-Employed

What is the best time to meet with your mentor?*

MorningLunchAfternoonEarly Evening

What are the preferred methods of communicating with your mentor?*

PhoneFace-to-face meetingsEmail

Describe your work history:*

What are your professional areas of interest? *

What are your personal interests? *

What are your community involvement areas of interest?*

What type of professional experience are you seeking in a mentor? *

What type of community experience are you seeking in a mentor? *

Do you have any personal or social barriers that you have overcome that would be helpful in matching you with a mentor and sharing similar life experience? *

What types of activities with your mentor, in addition to monthly meetings, would you find beneficial (e.g., attendance at networking events, board meetings, political functions, cultural events, etc.)?*

What do you hope to achieve from participating in this program?*

Is there anything else that we should know that would assist us in pairing you with a mentor?*