Changemaker Mentorship Program - Member Request Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The program matches a local expert with a Roundhouse member (you) for a set term where they will work to achieve co-created outcomes.

Please fill out this form to identify your needs and challenges to help us pair you with one of our expert consultants. We'll be in touch to chat about the options available.

Name (first and last) *

Organization Name

What stage of development is your business in?

Pre-Start Up

Start-Up

Growth and Development

Scaling

Mature

Clear selection

What are some of the specific challenges you are facing? Please provide some context and detail for your items. *

Select if you would like to be matched for a one-time appointment or a three-month term with the meeting frequency to be determined between the expert and yourself. *

One-time

Three-month term

Required

Indicate if there are specific topics you'd like to be matched with. Keep in mind we'll try pairing you with a specialist in their respective field. *

Human Resources

Program Evaluation

Fund Development/Alumni

Marketing

Social Mission/Brand

Fund Development

Evaluation

Entrepreneurs

Data Analytics

Industrial Design

Social Mission/Organizational Structure

Business Development

Accountability

Accounting/Taxes

Social Media

Other:

Required

Clear form

Never submit passwords through Google Forms.

This form was created inside of MacEwan University. Report Abuse

Forms