Mentoring Circles - Mentor Application

The Central Exchange mentoring circle program is expanding! We are pleased to offer this highly valuable benefit to our members and hope you'll participate! This form should be completed in its entirety for those wanting to be considered as a mentor for the 2018 mentoring circles. Applications will be accepted through January 12th and new circles will begin at the end of January or early February. Completion of this application does not guarantee you will be selected to be a mentor. Applicant submissions received after January 12th will be matched to an existing group. Only Central Exchange members may participate in this program.
What is your email address?
What does mentorship mean to you?
Please select your location preference
We will do our best to match you with a circle that meets your location desire however this can not be guaranteed
Please include your LinkedIn URL
Please list the name of the company you work for or own
What is your current job function?
What is your current job title?
What is one area that you are working on now for your own professional development?
What are the areas you feel you can mentor others on?
At the end of the twelve month cycle, what will success look like in your eyes?
Describe how you will measure and gauge success in the mentor/mentee relationship?
If we were to ask others about your strengths, what you previous supervisors, colleagues or subordinates share with us?
Amongst the same group identified above, how would they describe your communication style?
Previous Experience
Have you mentored others in the past?
Describe the skills, talents or challenges youi have overcome that you believe have prepared and positioned you to be a mentor.
How many times a year can you commit to meeting with your circle?