Mentor Selection Form

REMINDER: The selected mentor will be assigned to you temporarily and you'll be asked again after 4-5 mentoring sessions if you would like to change the mentor or not.

As much as possible, we don't recommend constantly changing the mentor because of the established goals and trust.

If you have any questions, please contact us.

Today's Date

Date

Mentee Name

First NameLast Name

Age

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Please select the mentor you prefer?

If the mentor is not available, who is your next choice?

Why did you select this mentor?

What are you expecting to learn in this program?

What are your goals during this program?

Select the topics you wish to discuss with your mentor.

As a mentee, are you willing to: (Please select your answers)