Mentorship Program Survey
Mentor: an advisor, guide, guru, counselor or consultant
Mentee: a person who is advised, trained or counseled by a mentor
Email address *
Name *
Your answer
Email adress *
Your answer
Phone Number *
Your answer
1. Would you like to be a mentor and/or a mentee? Please indicate if you are a Jaycee, a Jaycee Aged Senator or Aged Out Senator. *
Your answer
2. How long have you been a Jaycee and/or Senator? *
Your answer
3. What is your primary interest in a mentorship program? *
4. Write in additional details about your interest in the program (the more details provided, the easier it will be to match you up with a mentor/mentee of like interest): *
Your answer
5. What is your preferred timeframe/duration of mentor/mentee relationship? *
Your answer
6. What is your preferred structure for working with your mentor/mentee? *
7. Do you prefer to be paired with a mentor/mentee who is: *
8. What main challenge(s) would you like to address (as mentor or mentee)? *
Your answer
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