JHTC Mentorship Program: Mentor Application (2021)
Thank you for your interest in the JHTC Mentorship Program and taking the time to fill out this application. The submission deadline is Friday, October 2, 2020.

We’d like to engage as many participants as possible and rely on the information you provide below to evaluate and match mentees and mentors. Please answer all our questions completely and thoroughly to help us create a valuable and enjoyable experience for all.

We ask that you only apply if you are able to make a minimum six-month commitment. Participation in the Thursday, January 14th, 2021 Zoom kick-off meeting of the Mentorship Program is mandatory.
Email address *
Why do you want to participate in this program? (3-6 sentences/bullet points) *
What special skills, traits, or knowledge do you have? What makes you unique?
As a mentor, what do you see as your responsibilities to ensure success of the mentorship relationship? *
In the same context, what do you expect from your mentee? *
Have you participated in a mentorship relationship previously?
If yes to either, what value did you gain from the experience?
In what disciplines do you have expertise that would allow you to mentor others? *
What additional information would you like us to know when considering your application and mentee match?
Full Name *
Email *
Phone # *
Home City *
LinkedIn Profile or Web Page Link or other portfolio information you would like to share *
We strongly encourage you to include your LinkedIn profile URL. If you do not have a LinkedIn profile or other webpage to share, please indicate so.
Current Job Title/Occupation *
If you are not currently working, please tell us what you're doing (student, retired, looking for work, etc)
Name of Employer *
If you are not currently working, you can say N/A.
Employer City (Where do you work?) *
If you are not currently working, you can say N/A.
Educational Background
Clear selection
School Attended/ Degree *
Do you commit to participating in this program for a minimum of six months? *
Participation in the kick-off meeting of the Mentorship Program is mandatory. Can you participate in a meeting on the evening of Thursday, January 14th, 2021 from 7 to 9 pm? *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy