2026-27 ACHE of Georgia Mentorship Application - MENTEE

2026-27 Mentee Application

We are so excited that you have decided to take on the role of MENTEE in our 2026-27 ACHE of Georgia Mentorship Program. Before making the commitment to join the program, we want to ensure that you understand our purpose and YOUR ROLE in the program. Our program was designed to facilitate the professional growth and development of our members as they navigate their healthcare leadership journey. Mentees are provided with opportunities to connect with seasoned healthcare leaders, who will expose you to industry networking and facilitate growth of competencies.

As a way to help guide the Mentor-Mentee relationship, we ask that you agree to the following as part of the program:

The program runs from mid-October to July 1, 2027. Applicants must be able to commit to the entire program duration, as mentors have set aside dedicated time to provide guidance and support.
Arrange your first meeting with your mentor (virtual/F2F) within the first 30 days of the match and be prepared to set at least 3 mutual goals.
Engage with your MENTOR at least once per month. Virtual/F2F meetings will happen on an agreed-upon cadence.
Complete several online documents and surveys throughout the program that your MENTOR will review.
Understand that the MENTOR’s role is to advise you along your journey, NOT to find you employment.
Commit to giving your very best during the program.

You will receive an email notification with the name and contact information for your new MENTOR by mid-October. Please SAVE THE DATE for our Mentorship Program Launch EVENT on OCTOBER 22nd from 6:00pm-8:30pm (details to follow). Thank you for being a part of our program!

IMPORTANT: Please submit this application by Friday, September 4, so that we can match mentees and mentors before our program launch event this fall.

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1. Demographic information: (Required.)

First and Last Name

City

State

Cell Phone

E-mail address

LinkedIn Profile (if available)

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2. ACHE of Georgia membership level (you must be an ACHE member in Georgia to participate): (Required.)

Student member

Member

FACHE

LFACHE

Other (please specify)

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3. Have you participated in ACHE of Georgia's Mentorship Program before (check all that apply)? (Required.)

Yes, as a Mentor

Yes, as a Mentee

No, I am new to the ACHE of Georgia Mentorship Program

If you answered yes as a Mentor and/or Mentee: What is one thing that we can do to make this the best Mentorship Program yet?

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4. Are you currently enrolled as a student? (Required.)

Yes

If you are a student, please indicate your degree type and the school you are enrolled in.

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5. If you are a student, would you be willing to have another student as your MENTOR? (Required.)

Yes

N/A

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6. What is your current employment status? (Required.)

Entry Level (0-2 years)

Individual Contributor (Clinician, Associate, Analyst, Specialist, etc.)

Manager/Supervisor

Director/Executive Director

Vice President/SVP

C-suite Executive

I am not currently employed

Other (please specify)

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7. What is your current job title?

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8. For better clarity, please tell us what area of healthcare you work in. If you are currently unemployed, leave this blank. (allow up to 3 areas) (Required.)

Consulting

Clinical

Strategy & Planning

Healthcare Administration and Operations

Quality

Marketing/PR/Communications

Public Health/Policy

Population Health/Value Based Care

Finance and Revenue Cycle

Business Development

Research/Academia

Insurance payor/Managed care

Contracting/Legal

Human resources

Other (please specify)

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9. Who is your current employer? If you are currently unemployed, leave this blank.

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10. Please indicate your years of experience in healthcare leadership. (Required.)

1-5

6-10

11+

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11. Please enter your highest level of education completed.

Undergraduate degree

Graduate degree

Doctorate degree

Other degree(s)

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12. Please list professional credentials and certifications (i.e., RN/MD, FACHE, PMP, LSS, etc.): (Required.)

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13. What area(s) of healthcare would you like your MENTOR to work in or have experience in (please select up to 3, ranked in order of importance)?

Consulting

Clinical

Strategy & Planning

Healthcare Administration and Operations

Quality

Marketing/PR/Communications

Public health/Policy

Population Health/Value Based Care

Finance and Revenue Cycle

Business Development

Research/Academia

Insurance payor/Managed care

Contracting/Legal

Human resources

Other

It does not matter

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14. While we CANNOT GUARANTEE a specific match, if you have a Mentor in mind, please list their name here:

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15. Which best describes your reason for wanting a mentor? (Required.)

I am a student just entering the world of healthcare

I am an early or mid-careerist, looking for guidance on how to plan my career journey.

I am looking to transition from my current role into a new one

I am looking for guidance on strengthening my current role

I am looking for guidance on earning my FACHE

Other (please describe)

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* 1. Demographic information: (Required.)

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* 2. ACHE of Georgia membership level (you must be an ACHE member in Georgia to participate): (Required.)

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* 3. Have you participated in ACHE of Georgia's Mentorship Program before (check all that apply)? (Required.)

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* 4. Are you currently enrolled as a student? (Required.)

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* 5. If you are a student, would you be willing to have another student as your MENTOR? (Required.)

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* 6. What is your current employment status? (Required.)

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* 7. What is your current job title?

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* 8. For better clarity, please tell us what area of healthcare you work in. If you are currently unemployed, leave this blank. (allow up to 3 areas) (Required.)

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* 9. Who is your current employer? If you are currently unemployed, leave this blank.

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* 10. Please indicate your years of experience in healthcare leadership. (Required.)

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* 11. Please enter your highest level of education completed.

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* 12. Please list professional credentials and certifications (i.e., RN/MD, FACHE, PMP, LSS, etc.): (Required.)

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* 13. What area(s) of healthcare would you like your MENTOR to work in or have experience in (please select up to 3, ranked in order of importance)?

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* 14. While we CANNOT GUARANTEE a specific match, if you have a Mentor in mind, please list their name here:

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* 15. Which best describes your reason for wanting a mentor? (Required.)

1. Demographic information: (Required.)

2. ACHE of Georgia membership level (you must be an ACHE member in Georgia to participate): (Required.)

3. Have you participated in ACHE of Georgia's Mentorship Program before (check all that apply)? (Required.)

4. Are you currently enrolled as a student? (Required.)

5. If you are a student, would you be willing to have another student as your MENTOR? (Required.)

6. What is your current employment status? (Required.)

7. What is your current job title?

8. For better clarity, please tell us what area of healthcare you work in. If you are currently unemployed, leave this blank. (allow up to 3 areas) (Required.)

9. Who is your current employer? If you are currently unemployed, leave this blank.

10. Please indicate your years of experience in healthcare leadership. (Required.)

11. Please enter your highest level of education completed.

12. Please list professional credentials and certifications (i.e., RN/MD, FACHE, PMP, LSS, etc.): (Required.)

13. What area(s) of healthcare would you like your MENTOR to work in or have experience in (please select up to 3, ranked in order of importance)?

14. While we CANNOT GUARANTEE a specific match, if you have a Mentor in mind, please list their name here:

15. Which best describes your reason for wanting a mentor? (Required.)