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WISE Mentoring Application

Mentor Volunteer
Name:
Member No:
Position/Title:
Company:
Business Type:
Manufacturing Health Care Construction
Laboratory Government Service
Education Consulting Other
If you chose "other" business type...
Please Specify:

 

Contact Information:
Home Address:
Address Line 1:
Address Line 2:
City:
State:
Zip:
Country:
Work Address:
Address Line 1:
Address Line 2:
City:
State:
Zip:
Phone/Fax/Email:
Home Phone:
Cell Phone:
Work Phone:
Fax:
Email:

 

Resume (text only, please):
What knowledge can you bring to this program?
How can the mentoring program help you?

 

Please rank your strengths below from 1-5 (5 being the strongest). This will help identify the most appropriate person for you to mentor.
Network Development Strategic Thinking/Action
Influence Management Negotiating Politics/Culture
Career Planning Financial Acumen
Career/Family Balance Risk-Taking
Other
If you chose "other"...
Please specify:

 

Describe any mentoring experiences you have had:
What did you learn from your mentoring experience(s)?
Is there anything else that you think would be helpful for us to consider when evaluating your application?

Three WISE Mentoring Committee members will review your application, and you will be matched with an experienced volunteer from the program. Please allow 4-6 weeks for review and matching process completion. If you have any questions, contact one of the committee members listed below.

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