WIT // HSV Mentoring Program - Mentor Application 
Interested in mentoring @ WIT // HSV? Use form below to apply.

All information submitted as part of this mentor application shall be treated as confidential. In addition to this application, please submit a copy of your bio or resume to i2c@uah.edu.

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Email *
Welcome to WIT // HSV
Name: *
Email *
Phone: *
Company: *
Occupation / Title: *
LinkedIn profile: *
Introduced by / Reference:
Mentoring experience *
Required
Area of expertise *
Required
How did you hear about WIT // HSV?
What's your educational background?
What are some types of industries / projects which interest you? *
Why does mentoring at WIT // HSV interest you? *
What is your monthly commitment to the mentoring role? *
What mentoring experience do you currently have? *
Any felonies, lawsuits, convictions, bankruptcies and crazy stuff we need to know about? *
Anything else you want to tell us about yourself or your goals?
Acknowledgement
By hitting the "Submit" button I acknowledge that the above information is provided for the purpose of applying for the WIT // HSV Mentoring Program and is accurate to the best of my knowledge.  I understand that the WIT // HSV Team and related staff, advisers or parties retain sole decision whether this application is approved, disapproved or modified.

I understand that as a mentor participating in the WIT // HSV Mentoring Program, any support I provide in the course of the mentoring relationship is solely for the purpose of guiding the mentee in the field of enterprise. I understand this relationship is an educational resource to discuss issues confronted in building and scaling a business. I understand that the mentee may not rely on my statements as legal, financial or professional advice. I understand and agree that the information and advice I provide in the course of the mentorship will not be relied upon by the mentee as a substitute for his / her own independent judgment or professional opinions.

I agree to hold harmless The University of Alabama in Huntsville, the University of Alabama System, The Trustees of the Alabama System, I²C, WIT // HSV, its’ staff, employees, agents, volunteers, officers and related boards from any and all claims, injury, cause of action whatsoever, whether previously, now or hereafter incurred, from any acts or omissions by these entities, as a result of my participation in the WIT // HSV Mentoring Program.  I agree that these offices assume no responsibility for the success or failure of the mentee's existing or proposed business venture.  The role of these entities is consultative in nature and any advice or information offered may or may not be used per my discretion.

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Thanks for your interest. Now hit the "Submit" button and we will be in touch with you regarding next steps!

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