LIA Mentor Program- Mentor Application

Thank you for your interest in becoming a Mentor with the Laser Institute! Our mentorship program connects experienced professionals with individuals seeking guidance, support, and deeper engagement within the laser, photonics, and laser safety community. Your expertise can make a meaningful impact on the next generation of professionals in our field. This application helps us match you with the right mentee based on your experience, interests, availability, and mentoring style. If you have any questions, please contact us at membership@lia.org

🔵 SECTION 1 — Contact Information

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1. Full Name (Required.)

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2. Email Address (Required.)

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3. Phone Number (Required.)

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4. Organization (Required.)

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5. Job Title (Required.)

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6. Country & Time Zone (Required.)

🔵 SECTION 2 — Professional Background

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7. Brief overview of your professional background (Required.)

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8. Key areas of expertise (select all that apply) (Required.)

Laser Safety

Hazard Analysis

Optical Engineering

Manufacturing Processes

Research & Development

Standards & Compliance

Leadership / Career Guidance

Other (show “Please specify” field)

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9. Years of experience in laser-related fields (Required.)

🔵 SECTION 3 — Mentorship Preferences

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10. What type of mentee would you best support? (Required.)

Students

Early-career professionals

Mid-career professionals

Career transitioners

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11. Preferred meeting frequency (Required.)

Monthly

Twice per month

Flexible

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12. Preferred meeting format (Required.)

Zoom

Phone

🔵 SECTION 4 — Motivation & Availability

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13. Why would you like to serve as a mentor with LIA? (Required.)

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14. What best describes your mentoring style? (Check all that apply) (Required.)

Challenger: Pushes the mentee beyond their comfort zone with difficult questions and accountability.

Cheerleader: Provides positive reinforcement, confidence-building, and support to help mentees grow.

Connector: Helps mentees build their professional network by introducing them to valuable contacts.

Coach: Focuses on developing specific skills and guiding the mentee through goal-setting and performance improvement.

Educator: Focuses on teaching, training, and sharing knowledge to help mentees develop a deep understanding of a subject.

Other (please specify):

🔵 SECTION 5 — Personal Questions (Optional)

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15. What are some hobbies outside of work?

🔵 SECTION 6 — Agreement

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16. I understand that mentor/mentee matches are based on experience, goals, and availability. (Required.)

I understand

LIA Mentor Program- Mentor Application

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* 1. Full Name (Required.)

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* 2. Email Address (Required.)

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* 3. Phone Number (Required.)

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* 4. Organization (Required.)

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* 5. Job Title (Required.)

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* 6. Country & Time Zone (Required.)

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* 7. Brief overview of your professional background (Required.)

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* 8. Key areas of expertise (select all that apply) (Required.)

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* 9. Years of experience in laser-related fields (Required.)

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* 10. What type of mentee would you best support? (Required.)

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* 11. Preferred meeting frequency (Required.)

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* 12. Preferred meeting format (Required.)

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* 13. Why would you like to serve as a mentor with LIA? (Required.)

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* 14. What best describes your mentoring style? (Check all that apply) (Required.)

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* 15. What are some hobbies outside of work?

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* 16. I understand that mentor/mentee matches are based on experience, goals, and availability. (Required.)

1. Full Name (Required.)

2. Email Address (Required.)

3. Phone Number (Required.)

4. Organization (Required.)

5. Job Title (Required.)

6. Country & Time Zone (Required.)

7. Brief overview of your professional background (Required.)

8. Key areas of expertise (select all that apply) (Required.)

9. Years of experience in laser-related fields (Required.)

10. What type of mentee would you best support? (Required.)

11. Preferred meeting frequency (Required.)

12. Preferred meeting format (Required.)

13. Why would you like to serve as a mentor with LIA? (Required.)

14. What best describes your mentoring style? (Check all that apply) (Required.)

15. What are some hobbies outside of work?

16. I understand that mentor/mentee matches are based on experience, goals, and availability. (Required.)