FMP Mentor Sign-up Survey & Matching Assessment Form
Thank you so much for your interest in joining as a MENTOR 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 MENTEE looking to sign-up, please complete this form: https://forms.gle/YfHHv76XEDs8e4vbA
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?
What skills/ interest areas/ career areas could you mentor a mentee on?
What are you hoping to get out of your mentoring experience?
What are your top passions/ interests/ hobbies?
What are 3 words that would best describe you?
Describe your ideal mentee
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 Mentee?
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

Google Forms