This form is intended for those applying to participate as a mentee in the Coaching & Mentoring Leadership Academy. If you are looking to nominate someone else to participate as a mentee in this program, please fill out the mentee nomination form.
COACHING & MENTORING LEADERSHIP ACADEMY

MENTEE APPLICATION

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* 1. Name

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* 2. Employee ID#

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* 3. Civil Service Title:

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* 4. Office Title:

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* 5. Development/Department

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* 6. Office Address:

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* 7. Office Phone:

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* 8. Cell Phone:

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* 9. Name of Immediate Supervisor:

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* 10. Name of EVP, VP or Director:

Application Questions
Please answer all of the following questions as completely as possible.  If more space is needed use an extra sheet of paper.  The answers to these questions will aid us in the matching process.

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* 11. Please provide a brief description of your past work experience and current job responsibilities.  Please provide a copy of your resume if you have one.

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* 12. Attach a copy of your resume

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 13. Why do you want to participate in the Coaching & Mentoring Leadership Academy program? Please describe how a mentoring program would benefit you.

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* 14. What are your long-term and short-term career goals?  Identify positions which will help you to achieve your long-term goals.

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* 15. Are there any specific areas that you would like to focus on within the Leadership Academy?

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* 16. Briefly describe your expectations from the Coaching & Mentoring Leadership Academy?

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* 17. What do you hope to gain from the Coaching & Mentoring Leadership Academy?