Pay It Forward: Mentoring Our Future Leaders (Mentor)

Mentor Interest Form

Pay It Forward is a cross-industry mentoring engagement program that pairs young professionals with executives from Chamber member companies (member companies must be in good standing. Find out if your company is a Chamber member »). Pay It Forward participants meet formally as a group and are also encouraged to meet one to two hours per month on an individual basis. Pairings are made based on personal and professional goals and interests, competencies, experience and expectations.

If you are interested in participating in the next Pay It Forward cohort, please fill out this brief questionaire.

Please contact Patty Day at pday@chamberphl.com or (215) 790-3725 if you have any questions.

Question Title

* 1. Contact Information

Name

Title

Employer

City

State

Preferred Email

Preferred Phone

Question Title

* 2. Please list memberships and positions in other organizations.

Question Title

* 3. Areas of Experience/Expertise

On a scale of 1 to 5, with 1 being inexperienced and 5 being experienced, please tell us your level of expertise in the following areas. Your response should reflect your confidence and ability to mentor in these areas.

	Inexperienced	Somewhat Experienced	Experienced
Building Industry Credibility	Building Industry Credibility Inexperienced	Building Industry Credibility Somewhat Experienced	Building Industry Credibility Experienced
Communication	Communication Inexperienced	Communication Somewhat Experienced	Communication Experienced
Community or Business Development	Community or Business Development Inexperienced	Community or Business Development Somewhat Experienced	Community or Business Development Experienced
Corporate Culture	Corporate Culture Inexperienced	Corporate Culture Somewhat Experienced	Corporate Culture Experienced
Decision Making	Decision Making Inexperienced	Decision Making Somewhat Experienced	Decision Making Experienced
Organizational Change	Organizational Change Inexperienced	Organizational Change Somewhat Experienced	Organizational Change Experienced
Networking	Networking Inexperienced	Networking Somewhat Experienced	Networking Experienced
Personal Branding	Personal Branding Inexperienced	Personal Branding Somewhat Experienced	Personal Branding Experienced
Strategic/Tactical Planning	Strategic/Tactical Planning Inexperienced	Strategic/Tactical Planning Somewhat Experienced	Strategic/Tactical Planning Experienced
Team Building	Team Building Inexperienced	Team Building Somewhat Experienced	Team Building Experienced
Time Management	Time Management Inexperienced	Time Management Somewhat Experienced	Time Management Experienced

Pay It Forward: Mentoring Our Future Leaders (Mentor)

Mentor Interest Form

Question Title

* 1. Contact Information

Question Title

* 2. Please list memberships and positions in other organizations.

Question Title

* 3. Areas of Experience/Expertise

On a scale of 1 to 5, with 1 being inexperienced and 5 being experienced, please tell us your level of expertise in the following areas. Your response should reflect your confidence and ability to mentor in these areas.

Question Title

* 4. What are your expectations of a mentee?

Question Title

* 5. What are your expectations as the mentor?

Question Title

* 6. Is there anything else that you would like us to know?

Question Title

* 1. Contact Information

Question Title

* 2. Please list memberships and positions in other organizations.

Question Title

* 3. Areas of Experience/ExpertiseOn a scale of 1 to 5, with 1 being inexperienced and 5 being experienced, please tell us your level of expertise in the following areas. Your response should reflect your confidence and ability to mentor in these areas.

Question Title

* 4. What are your expectations of a mentee?

Question Title

* 5. What are your expectations as the mentor?

Question Title

* 6. Is there anything else that you would like us to know?

* 3. Areas of Experience/Expertise

On a scale of 1 to 5, with 1 being inexperienced and 5 being experienced, please tell us your level of expertise in the following areas. Your response should reflect your confidence and ability to mentor in these areas.