Become a Mentor

Mentor Application

Step 1. Ensure that you are currently a registered member with ACEL. If you are not, please fill out the membership application first and pay your membership dues.

Step 2. Fill out the form below as your digital application.

After you have completed these 2 steps, you will hear from us shortly!

Your Contact Information
Name*
Prefix First Last
Preferred to be called
Email*
Mobile Phone*
Home Phone
Work Phone
Address
Street Address City State ZIP Code
Convenient areas to meet your mentee*
Emergency Contact Information
Emergency Contact Name*
First Last
Emergency Contact Phone*
Emergency Contact Relationship to you*
Work/School Information
Employer Name
Industry
Position
Highest Level of Education Obtained*
Tell Us About Yourself
What experiences or skill sets would you like to offer as a mentor?*
How would you describe your ability to train, empower or coach?*
Please upload your resume, CV, or biography*
Please upload your head shot*
Program Requirements
A successful mentoring relationship requires a commitment of time and effort from both parties. Mentees, it’s up to you to take responsibility for your goals, ask questions and keep your Mentors updated on your progress. Mentors, we ask that you set aside time in your busy schedule to provide a listening ear and coaching for your Mentees.
The program requires a 12 month commitment (Aug-July). Describe your schedule, existing commitments (work, family, volunteer, etc), and any situations (moving, changing jobs, family situations, travel, etc) that may make this challenging.*
Can you commit to having an electronic conversation (phone, text, email, social media, etc) with your mentee at least once a week? If not, please explain why.*
Can you commit to having a face-to-face meeting with your mentee at least one a month? If not, please explain why.*
The ACEL Mentorship Program has four mandatory events for both mentors and mentees to attend. Mark all that you can attend.*
- Matching Interview (February 8th for 1/2 hour between 8 AM and noon)
- Orientation & 1st Face-to-Face Meeting (March 25th 5:30-7:30 PM)
- Goal Setting and 2nd Face-to-Face Match Meeting (April 29th 5:30-7:30 PM)
- Graduation (January 9 2021, 5-8 PM)
Signature of Agreement
I understand that the ACEL-Phoenix Mentorship Program is a voluntary program whose success depends on the level of participation of both Mentor and Mentee. I understand that while the ACEL-Phoenix MentorshipCommittee will make every effort to match me with an appropriate Mentee, the Mentorship Committee is not responsible for the performance of my Mentee, nor can the Mentorship Committee guarantee a match.

I understand that any breach of confidentiality between my Mentee and me will be grounds for dismissal from the Mentorship Program. I agree to inform my Mentee and the Mentorship Committee should I no longer be able to participate as a Mentor.

I verify that the information on this application is true to the best of my knowledge. I understand that I will be required to go through an orientation before I can participate in the Mentorship Program.
Signature
First Last
Date
Date Format: MM slash DD slash YYYY

Become a Mentor

Mentor Application

Your Contact Information

Emergency Contact Information

Work/School Information

Tell Us About Yourself

Program Requirements

Signature of Agreement