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CEPE Professional Mentorship/Coaching Intake Form
Thank you for your interest in Professional Mentorship/Coaching!
Please fill out this form. Your answers will help our staff find the best possible match for you. Once the potential mentor is identified, we will notify you about registration.
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1.
Name
(Required.)
*
2.
Email
(Required.)
*
3.
Phone Number
(Required.)
*
4.
LinkedIn Profile URL
(Required.)
*
5.
What do you hope to achieve from the 1:1 sessions with a mentor?
(Required.)
To change your career trajectory and to seek guidance in identifying transferable skills and resume review
To advance within your current career and seek help creating strategic plan for the next level success
To seek a deeper understanding of the core concepts covered in a CEPE program and guidance in developing implementation plans for your organization's specific needs
Other (please specify)
6.
Please tell us more about your desired outcomes from this mentorship program.
7.
Please tell us if you already have a CEPE mentor in mind that you would like us to know about.
8.
How did you find out about this program?
CEPE website
Email/CEPE newsletter
Social Media
In CEPE class
Employer
Word of mouth
Other (please specify)
9.
Additional comments:
