BITS Peer Mentor Intake Form
Thank you for your interest in becoming a Peer Mentor. Please complete this form and we will be in touch with you shortly. All information is treated as confidential and will be used for assessment purposes only. For further inquiries please e-mail kyle@businessinthestreets.com.
Name (First and Last)
Your answer
Phone Number (Numbers Only):
Your answer
E-mail:
Your answer
Age:
Your answer
Have you participated in any BITS programs before?
Please indicate your highest level of education completed:
Area of study:
Your answer
Additional courses or training:
Please include courses applicable to the BITS Peer Mentor role i.e. small business management courses, leadership, public speaking etc.
Your answer
How did you hear about BITS?
Your answer
Why are you interested in mentoring for BITS?
Your answer
What, if any, experience do you have with small business or entrepreneurship?
Your answer
What is your current occupation?
Please check all that apply.
Required
BITS programs require a commitment of approximately 3-5 hours per week, for about 6-8 weeks. Will you be able to accommodate the program?
Which time slots work best for you to participate?
Required
LinkedIn Profile (if applicable)
Your answer
Additional comments:
Your answer
I hereby certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me from mentoring.
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