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C4 Mentorship Program
Contact Information
(Required.)
Date:
Name:
Current Title:
Company:
Email:
LinkedIn:
Twitter:
Other Relevant Social:
Work Address:
City:
Province:
Phone:
Preferred language:
(Required.)
English
French
Length of time with current employer:
(Required.)
Years of channel work experience (please check the appropriate box):
(Required.)
1-5 years of experience
6-10 years of experience
10+ years of experience
Goals & Objectives
It is important that we understand your goals and preferences to make the best possible mentor match. Please note that while C4 strives to make the best possible match, it may not be possible match all applications.
Have you had a mentor(s) in the past?
(Required.)
Yes
No
Was it
(Required.)
Formal?
Informal?
If you have been involved in another mentorship program, please tell us about the organization and program:
(Required.)
What would you regard as positive outcomes of a successful mentorship relationship? What does success look like to you?
(Required.)
Of the following professional priorities/areas of focus, please indicate the top three on which you would focus a mentorship opportunity.
(Please add to the following list if you have a priority not listed)
(Required.)
I want to develop and advance my career
Enhance my channel leadership potential
Expand my influence
Hone my management and people-management skills
Stay relevant with changing industry realities/dynamics
Other (please specify)
In addition to the above goals for mentorship, which of the following channel competencies would you most like to develop
(please select up to three):
(Required.)
Strategy development
Financial acumen
Change management
Channel Building
Marketing
Operations
Talent Management
Leadership
What positive attributes and/or experiences/skills would you bring to a mentorship relationship and be able to share with your mentor?
(Unique/interesting experience; perspective; attitude; competence/ability)
(Required.)
Is there anything else that we might have missed or should be aware of to create a workable partnership for you?
(Required.)
Expectations of Program Participants
I have read and understand the
expectations of participating
in the C4 Mentorship Program.