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JHTC Mentorship Program: Mentor Application (2019)
Thank you for your interest in the JHTC Mentorship Program and taking the time to fill out this application. Submission deadline: Thursday, December 20th, 2018.

We ask that you only apply if you are able to make a minimum six month commitment. Participation in the January 30th kick-off meeting of the mentor program is mandatory.

Full Name *
Your answer
Email *
Your answer
Phone # *
Your answer
Home City
Your answer
LinkedIn Profile or Web Page Link or other portfolio information you would like to share
Your answer
Current Job Title/Occupation
Your answer
Name of Employer
Your answer
Employer City (Where do you work?)
Your answer
Educational Background
School Attended/ Degree
Your answer
Interests/Hobbies
Your answer
Can you commit to participating in this program for a minimum of six months? *
Participation in the kick-off meeting of the mentorship program is mandatory. Can you participate in a meeting on the evening of Wednesday, January 30th from 7 to 9 pm in the Palo Alto area? *
Why do you want to participate in this program and what expectations do you have for your mentoring relationship? *
Your answer
Have you participated in a mentorship relationship previously?
If yes to either, what value did you gain from the experience?
Your answer
In what disciplines do you have expertise that would allow you to mentor others?
What special skill, trait, or knowledge do you have? What makes you unique?
Your answer
What additional information would you like us to know when considering your application and mentee match?
Your answer
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