2022-2023 Mentor Application
Fill out this form if you are interested in participating as a MENTOR in HPBA's Women's Mentoring Program when it resumes for a second time in 2022-2023.

The mentoring program is for women HPBA members in the hearth and outdoor living industry.

Please fill out the form below to sign up to be a mentor. If you also would like to sign up to be a mentee, fill out the mentee form (https://forms.gle/SmuCrZtHPZJiJ3Av5).

Contact Amie Ryan (ryan@nficertified.org) if you have any questions.

Learn more on our website: http://www.hpba.org/womensmentoringprogram
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Email *
Are you a current HPBA member (this is an HPBA-member-only program)? *
If you are not sure whether you're an HPBA member, we will reach out to you to confirm your membership status.
If selected for the program, do you commit to meeting with your mentee at least once a month and if you (for whatever reason) need to exit the program, commit to making arrangements with your mentee? *
Name (First and Last) *
Title *
Company Name *
Company: Street Address *
Company: City, State/Province, Zip Code *
Company: Country *
Preferred contact phone number (XXX-XXX-XXXX): *
What kind of phone number is your preferred contact number? *
Sector *
Years worked in the industry *
If you worked in a different industry before the hearth industry, in what industry(ies) did you work and for how many years?
Your ideal mentee would work in what sector? *
Do you have a preference regarding where your mentee is located? *
Why are you interested in becoming a mentor? *
What areas of experience can you share with your mentee? *
How do you achieve work-life balance? *
What are your interests outside of your job? *
How would you describe yourself in one sentence? *
How would you describe your ideal mentee? *
At the end of the structured mentoring period, what would constitute a successful outcome for you personally? *
Is there any other information you'd like to share?
A copy of your responses will be emailed to the address you provided.
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