Mentor Interest Form
Mentor Door County supports education and connection for young women of Door County through educational opportunities, career development, networking and one-on-one mentorships. Mentorships create supportive connections to cultivate personal, career and academic confidence and success.

If you are interested in becoming a part of Mentor Door County, please read the following guidelines and complete the survey below. A member of our team will be in touch with you within a few weeks of your completion of this survey. Feel free to explore our Facebook (https://www.facebook.com/mentordoorcounty) and let us know if you have any questions or concerns (mentordoorcounty@gmail.com).

1.Participation is voluntary and free of charge.
2. There will be an initial orientation for mentors to discuss guidelines, expectations and confidentiality. Please stay tuned for more information regarding the details of this meeting.
3.Participants are willing to engage in education or connections via in-person,
online, phone or virtual connections.

During the COVID-19 pandemic, in-person mentoring connections will comply with health guidelines determined by the CDC or Door County Public Health.
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Name *
Age *
Phone Number *
Alternative Phone Number
Email Address *
Residential Address *
I am interested in participating as a... *
I am interested in engaging in the following activities: *
Required
What qualities, skills or other attributes do you feel qualify you to be a mentor? *
What do you hope to gain from participating in mentorship? *
List any career interests, hobbies, and/or current community involvement activities. *
List any primary topics of interest to you.
Please indicate your employment status: *
Choose the highest level of education completed: *
If currently enrolled, indicated the name of the school, technical college, college, or university.
What else should we know about you?
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