EDCO Mentorship Program – Mentor Intake Form

So you are interested in becoming a Mentor…

The information you provide below will assist EDCO Staff in recommending a Mentee that is seeking an individual with similar educational background or work experience as you, or will benefit from your area of specialization. Once a match has been identified, we will assist in providing tools to help you to further build your mentoring skills.

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 and/or recent positions you may have held with processional associations/organizations.

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* 4. Do you have a preferred Mentee?

Yes

If yes, please name that individual.

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* 5. What is your reason for applying to be a Mentor and what are you looking to gain or offer through the program?

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* 6. Describe your top 3 skills, attributes or competencies you feel you have that would benefit a Mentee.

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

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* 8. Have you previously participated in a formal Mentorship Program as a Mentor?

Yes

EDCO Mentorship Program – Mentor Intake Form

So you are interested in becoming a Mentor…

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 and/or recent positions you may have held with processional associations/organizations.

Question Title

* 4. Do you have a preferred Mentee?

Question Title

* 5. What is your reason for applying to be a Mentor and what are you looking to gain or offer through the program?

Question Title

* 6. Describe your top 3 skills, attributes or competencies you feel you have that would benefit a Mentee.

Question Title

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

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* 8. Have you previously participated in a formal Mentorship Program as a Mentor?

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