WildFlowers-HWG Mentor Application

Mentoring is a special partnership between two people based on commitment to the mentoring process, common goals/expectations of the partnership, and mutual trust and respect.

In mentoring there should be an "exchange" that takes place between both mentor and mentee that provides a rich and rewarding experience for both participants. We ask you to share your information so the program manager can match you in a mentoring relation-ship. Both you and your recommended mentor will have the opportunity to agree to the pairing before you are assigned to work together.

First name

Last name

Email

Phone

Company name

Company Email

How would you like to be contacted?

Email

Cell Phone

Both

Please provide a brief description of your current job; or previous job experience/position?

Describe what you consider to be your strongest general competencies (i.e., knowledge, skills, and abilities):

Describe what you consider to be your strongest technical competencies:

Provide additional technical competencies. If none, select, N/A.

How do you believe a mentee can benefit from your expertise and guidance?

What are your interests or hobbies outside of work?

Have you ever worked with a mentee?

Yes

No

If yes, briefly describe the experience.

What motivates you in taking on a mentorship role?

In the event we reach the maximum capacity for the current 12-month cohort, are you willing to be placed on a waiting list for the next cohort?

Yes

No

Other

For security purposes, we perform a reference check. Please provide the names and phone numbers for your references.

Reference #1 - First and Last Name

Phone Number

Reference #2 - First and Last Name

Phone Number