Empowerment Panel

Women’s Impact Mentoring Program Expression of Interest
*Denotes required fields
Name

Title*

Organization*

Work Address

Home Address*

Work Email

Preferred Email*

Preferred Phone*

Mentoring occurs when two individuals begin a relationship where one teaches and counsels the other. Mentoring is a key component for success. There are two broad types of mentoring: formal and informal.

Informal mentoring relationships can naturally develop between mentor and mentee in certain situations such as on the job, in volunteer positions, or within organizations.

We offer a formal mentoring that is more structured. A mentor and mentee are matched based on a variety of factors and participate through an outlined program.

Program Expectations

Participants must be a current member of Women’s Impact. Mentoring relationships will be in place from September through May. Mentees and Mentors should plan to interact at least six times during that time period. The Committee asks that participants evaluate their experience and submit the information at the conclusion of the program. If for any reason the Mentee or Mentor are not satisfied with the program or are unable to continue with the program, we ask that you contact a committee member for discussion and resolution.

Confidentiality Agreement

By signing this confidentiality statement, I understand and agree that information shared between a Mentor and Mentee is confidential and to be protected.

Your signature*

Date*

About You

The following information will be compiled to create an individual profile that will be accessible only to the Mentoring Committee who will be making the matches. Please attach your résumé and or your bio.

Have you ever been mentored:
YesNo

Have you ever served as a mentor:
YesNo

Please indicate your preferred times of day/weekends and locations/area of town to meet.

Times:

Location:

What highlights from your career, community involvement, or volunteer experience would you like the Mentoring Committee to know in finding you a suitable match?

Please outline your civic activities and volunteer experience.

What are your core strengths?

Please list a key obstacle or challenge that you have been able to overcome in your career.

Hobbies and interests

What would make this a successful mentoring experience?

Is there anything else you would like us to know?

Please leave this field empty.

Women’s Impact Mentoring Program Expression of Interest
*Denotes required fields
Name

Title*

Organization*

Work Address

Home Address*

Work Email

Preferred Email*

Preferred Phone*

Mentoring occurs when two individuals begin a relationship where one teaches and counsels the other. Mentoring is a key component for success. There are two broad types of mentoring: formal and informal.

Informal mentoring relationships can naturally develop between mentor and mentee in certain situations such as on the job, in volunteer positions, or within organizations.

We offer a formal mentoring that is more structured. A mentor and mentee are matched based on a variety of factors and participate through an outlined program.

Program Expectations

Participants must be a current member of Women’s Impact. Mentoring relationships will be in place from September through May. Mentees and Mentors should plan to interact at least six times during that time period. The Committee asks that participants evaluate their experience and submit the information at the conclusion of the program. If for any reason the Mentee or Mentor are not satisfied with the program or are unable to continue with the program, we ask that you contact a committee member for discussion and resolution.

Confidentiality Agreement

By signing this confidentiality statement, I understand and agree that information shared between a Mentor and Mentee is confidential and to be protected.

Your signature*

Date*

About You

The following information will be compiled to create an individual profile that will be accessible only to the Mentoring Committee who will be making the matches. Please attach your résumé and or your bio.

Have you ever been mentored:
YesNo

Have you ever served as a mentor:
YesNo

Please indicate your preferred times of day/weekends and locations/area of town to meet.

Times:

Location:

What highlights from your career, community involvement, or volunteer experience would you like the Mentoring Committee to know in finding you a suitable match?

Please outline your civic activities and volunteer experience.

What are your core strengths?

Please list a key obstacle or challenge that you have been able to overcome in your career.

Hobbies and interests

What would make this a successful mentoring experience?

Is there anything else you would like us to know?

Please leave this field empty.