Mentorship Application Form - Mentor
Email address *
Name *
Your answer
Pronouns (e.g. He/Him, She/Her, They/Them, etc.). Select all that apply. *
Required
Employer *
Your answer
Job title *
Your answer
City and state *
Your answer
Medium(s) you are currently working in *
Required
Years of professional experience: *
Your answer
Are you able to do any of the following? *
Required
Do you agree to have at least one check-in with your mentee per quarter? *
Do you have any identities that you would like us to take into consideration when making your pairing (e.g. POC, trans, nonbinary, etc.)? Please specify.
Your answer
Is there anything else you would like us to know?
Your answer
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