Mentee Intake Form - Hertz Community Mentoring
The purpose of this form is to collect information from prospective mentees in the Hertz Community Mentoring program. Please be aware that information shared here will be available to all prospective mentors - please do not share confidential information.
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Please provide your name.
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Please provide your preferred contact email (which will be shared with all prospective mentors).
What kind of guidance are you seeking from a mentor? What do you need most? Try to be as specific as possible.
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How do you prefer to connect with your mentor?
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What years were you in graduate school? (Use anticipated graduation year if you are still in school.)
Please provide your age, if you would like.
Please share your gender here, if you would like.
Please share your race and ethnicity here, if you would like.
Please share aspects of your previous education or work experience that are relevant to your mentoring need.
Anything else you want to share can go here!
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This form was created inside of Fannie and John Hertz Foundation.

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