Mentee Application

Your name *

Email address *

Phone Number

Motivation and Experience

Why do you want to be mentored? *

Describe any particular situations in your life that may be prompting the desire to be mentored.

Have you been mentored before? If so, please briefly describe that experience.

List any adults that you would consider as a positive influence in your life. *

Acknowledgements

I'm willing to meet the role's expectations *

As described in the Mentee Role Definition (http://bit.ly/mentee-role)

I'm willing to commit to this role for a full 12 months. *

Unless otherwise discussed with the Program Director

I acknowledge that after my initial meeting with a potential Mentor, I will be required to review and complete the Mentorship Covenant to be fully enrolled in the program. *

As described in the Mentorship Covenant (http://bit.ly/mentorship-covenant)

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