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JHTC Mentorship Program: Mentee Application (2019)
Thank you for your interest in the JHTC Mentor 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 *
Email *
Phone # *
Home City *
LinkedIn Profile or Web Page Link or other portfolio information you would like to share
Current Job Title/Occupation
Name of Employer
Employer City (Where you work)
Educational Background *
School Attended/Degree
Interests/Hobbies
Can you commit to participating in this program for a minimum of 6 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 and expectations do you have for the mentoring relationship? *
As a result of this program, what changes do you expect in your personal behavior, leadership, career, or work? How will these changes benefit you?
What are the career goals or professional development areas that you would like to explore with a mentor? (e.g., type of role and/or organization to which you aspire, competencies you want to further develop, etc.) *
Understanding that not all requests are possible, in what disciplines would you like your mentor to have expertise?
What additional information would you like us to know when considering your application and mentor match?
We invite you to share a short video (2 minutes or less) of yourself explaining why you think you should be selected. Submission of a video is optional. You are welcome to use this same mentee link (a second submission) to submit your video at a later time.
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