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CQI Community Mentorship Program Mentor Application

Mentor Application

Thank you for your interest in participating in our continuous quality improvement (CQI) professional mentorship program. During this 6-month program, mentor/mentee pairs will build a mutually beneficial relationship that will strengthen skillsets and support career growth. Please note that based on mentee applications and interests, not everyone who applies may be matched with a mentee.

There will be a required mentorship kick off meeting on March 18, 2027 and the program will run from April through September. Mentor/mentee pairs are expected to meet at least monthly over the course of the program. There will a mentor group check-in on May 20 and an all-cohort pre-closing meeting on August 19th. The Closing session of the program will be on September 23.
1.Background Information:(Required.)
2.Please upload a current resume:(Required.)
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3.Please share a current bio. (Note: This will be shared on the website and included on the mentee application as they rank their interest and preferences in working with mentors)(Required.)
4.Educational Background: Include the specific degree(s) below:(Required.)
5.What is the structure of quality improvement at your organization? (e.g., separate department, embedded within the program, team, single person)(Required.)
6.Size of organization:(Required.)
7.Type of Organization:(Required.)
8.Region served:(Required.)
9.Where do you fit within quality improvement at your organization? (e.g., part of the quality improvement department, program team, adjacent)(Required.)
10.Have you participated in a formal mentoring program before?(Required.)