Veterans Mentoring Program - Mentor Application

Registration Information

First Name

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Last Name

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If a veteran, please list branch and dates of service

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Career Field

Type of Organization / Industry

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Position Title

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Name of Company

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Street Address

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City

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State

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Zip Code

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E-Mail Address

Please enter a valid email address.

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Phone Number

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Contact Preference

Phone
Email
No Preference

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Company Website

Please enter a valid web address

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Best Hours to get in touch

8am-12pm
12-4pm
4-8pm
Other:

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Please provide a brief overview of your place of work

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Please give some examples of your daily job responsibilities

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We request 6 contacts with your mentee over the course of the semester. Of those contacts, 2-3 should be in person. We respect your time and obligations. Mornings, half-days, and meal-time activities work perfectly well. To follow is a list of some recommended activities you may want to have your mentee participate in: • Informational interview with you or with Human Resources • Tour of your facility • Shadow experience for a day or period of the day • Participation in department or client meeting • Participation in a work-related project • Work-related breakfast, lunch, or dinner event (not to include drinking or bar- type location)

Describe some activities you may have a mentee participate in

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Thank you for taking the time to complete this form. If you have any questions, please contact Stephanie Siddi at 845-574-4369 or ssiddi@sunyrockland.edu.