FMP Mentee Sign-up Survey & Matching Assessment Form
Thank you so much for your interest in joining as a MENTEE in the SF HIV FOG Mentor Program! We are thrilled that you would like to join our growing mentorship community.

The questions below will help us to understand your experience and interests and to find the best mentoring match for you. 

Please complete the survey below and reach out to Mentorship Manager Althea Karwowski at akarwowski@shanti.org with any queries or comments. 

We look forward to having you on board!

If you are a MENTOR looking to sign-up, please click here: https://forms.gle/QZVTHqcmpnSyXoye6 
Sign in to Google to save your progress. Learn more
First Name
Last Name
Email
Number
How do you describe your gender identity?
What are your pronouns?
What is your race/ ethnicity?
What values and qualities do you consider important for a mentor/mentee?
What is your current agency and job position/ function?
What communities do you work with?
How long have you been working in the field?
In which areas of your work would you like to grow and develop?
What are your professional areas of interest?
What are you hoping to get out of your mentoring experience?
What are some major challenges you are trying to overcome in your role at the moment?
What are your top passions/ interests/ hobbies?
What are 3 words that would best describe you?
Describe your ideal mentor
Do you have any matching preferences (e.g., I'd like someone who is bilingual. It'd be helpful to be paired with someone who is transgender or nonbinary. It'd be great to be paired with someone who has their clinical license). We cannot guarantee but will take into consideration as far as possible.
What is your preference of communication with your Mentor?
Clear selection
When would you be available to meet?
We would love to send you a program welcome package - please provide your sweatshirt size and mailing address below:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report