Mentor Application Form - The Bill Anderson Fund Mentoring Network
Thank you for considering volunteering with the Bill Anderson Mentoring Network. There are two options related to your involvement.

First, you may volunteer to be a participant in the Network itself. The Network is a geographically distributed and professionally and academically diverse group of individuals who are committed to supporting the increased engagement of individuals from underrepresented groups in work related to hazards, disasters, and emergency management. The individuals within the network are not actively engaged in day-to-day activity for the Bill Anderson Fund. All network members are signed up with and connected to one another via a communications platform. When a mentor working with a mentee finds the mentee needs support with an issue he/she is not best to address, the mentor will turn to the network for assistance by posting the issue to the Network through the platform. Based on the combination of each individual Network member’s willingness, knowledge, skills and abilities, and availability vis a vis the issue described by the mentor, Network members would reply to the mentor related to how they might assist on a case-by-case basis.

The second option for involvement within the BAF Mentoring Network requires more of an ongoing commitment. The second option is to serve as a mentor who would be matched to one mentee for a minimum of one year. BAF Mentors meet virtually or in person with their mentees for a minimum of 1 hour a month. BAF Mentors are matched to mentees on the basis of mentee self-identified academic, professional, or other needs and the ability of the mentor to support addressing those needs. All mentors are automatically a part of the Network.

Midway through this form, you will be prompted to let us know in which capacity you wish to be engaged initially with the BAF Mentoring Network.

Last Name
Your answer
Middle Initial/Other
Your answer
First Name
Your answer
Title
Your answer
Sex
Race/Ethnicity
Your answer
Departmental Affiliation
If applicable.
Your answer
Institutional/Organizational Affiliation
Your answer
Current Position Title
Your answer
Have you earned a doctoral degree?
Field in which doctoral degree earned (if applicable):
Note—If you have earned more than one doctoral degree, please include all degrees below.
Your answer
Have you earned a master's degree?
Field in which master's degree earned (if applicable):
Note—If you have earned more than one master's degree, please include all degrees below.
Your answer
Have you earned a bachelor's degree?
Field in which bachelor's degree earned (if applicable):
Note—If you have earned more than one bachelor's degree, please list all below.
Your answer
Preferred Contact Phone Number
Your answer
Mailing Address Line 1
Your answer
Mailing Address Line 2
Street Address Line 2 OR Apartment/Unit Number
Your answer
Mailing Address CITY
Your answer
Mailing Address STATE
Your answer
Mailing Address ZIP CODE
Your answer
Preferred Email Address
Your answer
Please identify the organizational setting(s) in which you HAVE worked:
Check as many as apply.
Required
Please describe your position(s) / role(s) in the above organizational settings:
Your answer
Please share your topical and/or issue interests related to hazards, disasters and/or emergency management.
Your answer
Please copy and paste current curriculum vitae or resume below:
Your answer
Thank you for considering volunteering with the Bill Anderson Network. There are two options related to your involvement. How would you like to be engaged initially as a volunteer with the BAF Mentoring Network?
Why do you want to be a Bill Anderson Fund Mentor?
Your answer
What specifically do you feel you have to offer as a Mentor?
Your answer
Please describe your supervisory and/or academic advising experience:
Supervisors are, according to BusinessDictionary.com, “Person[s] in the first-line management who monitors and regulates employees in their performance of assigned or delegated tasks. Supervisors are usually authorized to recommend and/or effect hiring, disciplining, promoting, punishing, rewarding, and other associated activities regarding the employees in their departments.” ——— Advisors provide students advice related to completing a degree program. Issues such as curriculum requirements, course schedules, timing and other requirements related to program benchmarks, registering for courses, navigating the academic organization where the student is seeking the degree, and directing thesis and dissertation work are commonly addressed by advisors.
Your answer
Please share your mentoring experience to date:
The concept of mentoring is complex and defines simple definition. Yet, for the purposes of this application, please describe your experience engaging in a relationship with another (or others) with the purpose of leveraging their personal skills, knowledge, and experience to support the academic, professional, and/or personal success of the other(s).
Your answer
Please identify the academic areas in which you most want to support a mentee:
Check as many as apply.
Please identify the professional areas in which you most want to support a mentee:
Check as many as apply.
Please identify any of these other areas in which you MOST want to support a mentee:
Check as many as apply.
Do you understand that the Bill Anderson Fund expects you to commit a minimum of 1 hour / maximum of 2 hours per month to the mentoring relationship?
Please identify preferred forums for communication:
Check all that apply.
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