ISSA KC Mentee Enrollment Form
Email address *
Mentee Name
Your answer
Mentee email Address
Your answer
How do you prefer to meet your Mentor?
Date
MM
/
DD
/
YYYY
Contact Phone number
Your answer
Best time to call you?
Your answer
Address
Your answer
Current Job
Your answer
Offices desired in chapter
Your answer
Security Domain Interests: Select areas you would like to learn more about
Work/Internship/Volunteer Experience
Your answer
Why do you want to participate in the Mentor Program?
Your answer
Eduction
Major
Your answer
Year in School:
Your answer
College/University:
Your answer
Expected Graduation Date:
Your answer
ISSA Code of Ethics
I will adhere to ISSA’s Code of Ethics and Standards of Professional Conduct, https://www.issa.org/?page=CodeofEthics. Submission of this application is your agreement to comply.

Disclaimer
The Kansas City Chapter of ISSA is not responsible for the accuracy of content provided by mentors. The information is provided for educational purposes only. It is intended to help you learn and gain skills to further your career and to provide professionals an opportunity to share their knowledge and skills with others who are seeking to expand theirs in a specific of study. This program does not provide any guarantees for job placement or advancements in your career. It is not intended to certify you for a specific skill or area of knowledge. It should not be used in place of professional study or certification. The statements made by mentors are their opinions and have not been proven or evaluated by ISSA. ISSA assumes no responsibility for the use or misuse of materials and information you receive from your mentor.

A copy of your responses will be emailed to the address you provided.
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