EDCO Mentorship Program – Mentee Intake Form

So you are interested in becoming a Mentee…

The information you provide below will assist EDCO Staff in recommending a Mentor that best suits your educational, professional or personal needs. Every attempt will be made to pair you with your preferred Mentor (if indicated) however availability and commitment may affect our ability to do so.

By completing this application, you acknowledge that the information provided will be used by EDCO solely for the purposes of Mentor / Mentee matching. You also agree to respect the confidentiality of the mentoring relationship. Discussions that take place with your mentor shall remain private and will not be shared with anyone unless agreed to by each party.

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* 1. In this section, please provide your contact information.

Name

Geographic Area

Job Title

Email Address

Phone Number

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* 2. How long have you held your current job? AND How long have you worked in Economic Development?

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* 3. Briefly outline your educational background.

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* 4. Do you have a preferred Mentor?

Yes

If yes, please name that individual.

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* 5. What is your reason for applying to be a Mentee and what are you looking to gain from the program?

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* 6. What are your major career interests and goals?

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* 7. Describe the top three skills or competencies you would like to strengthen by working with a mentor.

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* 8. What hobbies or interests do you have outside of work?

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* 9. Have you previously participated in a formal Mentorship Program?

Yes

EDCO Mentorship Program – Mentee Intake Form

So you are interested in becoming a Mentee…

Question Title

* 1. In this section, please provide your contact information.

Question Title

* 2. How long have you held your current job? AND How long have you worked in Economic Development?

Question Title

* 3. Briefly outline your educational background.

Question Title

* 4. Do you have a preferred Mentor?

Question Title

* 5. What is your reason for applying to be a Mentee and what are you looking to gain from the program?

Question Title

* 6. What are your major career interests and goals?

Question Title

* 7. Describe the top three skills or competencies you would like to strengthen by working with a mentor.

Question Title

* 8. What hobbies or interests do you have outside of work?

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* 9. Have you previously participated in a formal Mentorship Program?

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* 10. Is there anything else we should know about you in order to make a good Mentor match for you?