Mentor Application

Mentoring is a special partnership between two people based on commitment to the mentoring process, common goals/expectations of the partnership, and mutual trust and respect. Mentoring is a “get and give” experience with the goal of providing a rich and rewarding experience for both partners. We ask you to share your information so the program manager can match you in a mentoring relationship. Both you and your recommended mentee will have the opportunity to agree to the pairing before you are assigned to work together.
Please submit your application to [insert program manager name and contact info] no later than [insert time and date].

Name:

Please indicate your title and place of work:

Phone Number:

Email Address:

Number of mentees you would like to mentor:

Please respond to the information requested below.

1. Why do you want to be a mentor?

2. List the series of positions and grades you have held:

3. Describe what you consider to be your strongest general competencies (i.e ., knowledge, skills, and abilities):

4. Describe what you consider to be your strongest technical competencies:

5. What do you think a mentee can learn from you?

6. What are your interests or hobbies outside of work?