Amplify Mentoring Circles - Interest Form
Amplify is launching mentoring circles for 2019! Mentoring Circles were launched in 2015 as a way to help and support others in their careers and personal lives, as well as a way to share expertise with one another. We keep our groups small - no more than 8 people - so that the groups can provide a safe space to ask questions and grow, as well as be authentic and vulnerable in our journeys. Our group members are required to pledge confidentiality in all group interactions. A kickoff and information call will be held prior to the group's first meeting to answer your questions and confirm whether this is something you'd like to commit to. Groups typically meet once a month for a 9 month period beginning sometime in March. We are also looking for group coordinators - if you are interested in taking on this responsibility, please let us know below!
Name *
Your answer
Email (we recommend using your personal email, not work)
Your answer
Company or Organizational Affiliation
Your answer
Select the pronouns that feel most affirming for you, or type your preferred pronoun below:
Preferred pronoun
Your answer
Feel free to share anything you'd like us or your group coordinator to know about your identity, including your racial or ethnic background. There are too many options for a multiple choice question!
Your answer
Do you identify as an underrepresented voice in technology?
Timezone
Have you participated in an Amplify Mentoring Circle before?
If yes, have you coordinated/facilitated a circle before?
Industry
What type of mentoring circle are you interested in? (Please select all that apply!)
If none of the above listed circles truly fits your needs/goals, please tell us what would!
Your answer
Are you interested in being the coordinator for your group? Checking this box indicates only interest, not commitment. An info session will be held within the next few weeks for you to learn more.
What are you hoping to gain from a mentoring circle?
Your answer
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