Mentor Application 

Hello! We are so excited that you are interested in becoming a ISAWWA Mentor! Please fill out this application so that we can learn more about you and match you with a mentee.

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* 1. Name

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* 2. Email address

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* 3. Mailing Address

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* 4. City, State and Zip

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* 5. Company

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* 6. Phone number (cell)

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* 7. Phone number (office)

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* 8. Current job title: 

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* 9. College degree earned

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* 10. Certification(s) license(s) held:

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* 11. You feel comfortable providing (select one or both)

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* 12. How many mentees would you like to work with at one time?

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* 13. You feel comfortable mentoring (choose one or both)

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* 14. Please describe your career path.  Think of the major jobs you have held and list the titles in sequential order.  This will give mentees an idea if you have followed a similar career path to the one they are on.  For example:  lab tech, child health consultant, chemist, lab supervisor. 

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* 15. Years you have worked in the water industry

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* 16. Describe what you do on a day-to-day basis at work.

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* 17. Do you have any previous experience mentoring?  If yes please explain. 

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* 18. What specific qualities, skills, or other attributes do you value in yourself and that you feel will be beneficial to a mentee?

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* 19. Describe what you consider to be your strongest technical and professional competencies, for example, pump maintenance, networking skills, career planning, water quality, etc.:

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* 20. How much time would you like to devote to mentoring? (select one)

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* 21. How far are you willing to travel to meet with your mentee? (select one)

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* 22. What do you think will be the most challenging aspect of being a mentor?

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* 23. What do you hope to gain by being a mentor?

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* 24. What do you like to do when you are not at work?

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* 25. What are your expectations for this mentoring experience?

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* 26. Is it okay for the ISAWWA Mentoring Program administration to communicate with you via email?

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