Mentor Sign-Up Form
The purpose of this form is to collect necessary information for the mentor-mentee match-up process.Thank you again for participating in our program!
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Are you currently a member of NTXISSA? (You must be a member of good-standing to be a mentor?) *
Name *
Phone Number *
Email *
Preferred communication method? *
Level of education? *
Are you employed? *
Do you have any certifications? If so indicate them below *
How many mentees would you be able to handle? (max numbers of mentees per mentor is 5, anything more than that must be approved by James Grisham) *
Can you dedicate at least one hour every two weeks per mentee? *
NTX requires a background check for each mentor, are you comfortable sharing private info for this purpose? If you have any questions about this you can reach out to our director James Grisham *
What are your strengths? *
Do you have a LinkedIn account? If so please provide a link to your profile  *
Questions or concerns about the program? *
Do you think cereal is soup? *
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