Mentor Information Form
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Full Name: *
Preferred First Name:
What type of library are you employed at? *
Institution: *
Job Title: *
Street Address: *
City: *
State: *
Zip Code: *
Preferred Phone Number: *
Preferred Email Address: *
Gender: *
If employed at a university/college, what accrediting agency(ies) is you institution under?
Number of Students (FTE)?
Educational programs or groups you currently serve (check all that apply) *
Required
Are you a Solo Librarian? *
What areas of the library are you responsible for? *
Years of service in current position? *
Total years in the library profession? *
What integrated library system or cataloging software is used at your institution? *
Do you have any other experience or expertise that could be helpful in a mentoring relationship? Please include other types of libraries where you've worked. *
Would you prefer to be paired with a mentor of the same sex? *
What are some of your hobbies or interests? *
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