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Step 1
Mentorship/Mentee Interest Form
Please complete the form below if you are interested in being considered for
this program
.
First & Last Name
Email Address
email
Phone Number
phone
I am interested in becoming a:
(Pick one)
Select An Option
Mentee
Mentor
Alternate Contact Method
phone
Which is your preferred contact method?
(Pick one)
Select An Option
Phone
Email
Alternative contact method
In-person
Best timeframe to reach you:
(Check all that apply)
Business hours: Mon-Fri; early morning (between 7-9 AM)
Business hours: Mon-Fri; mornings (between 9 AM - 12 PM)
Business hours: Mon-Fri; afternoons (between 12-5 PM)
Business hours: Mon-Fri; evenings (between 5-8 PM)
Saturday & Sunday mornings between 9a-12p
Saturday & Sunday afternoons between 12p-4p
Saturday & Sunday between 4p-8p
How long have you been a continuous member of NAAAHR?
(Pick one)
Select An Option
New member (less than one year)
1-2 years
2-4 years
4+ years
Demographic Background Information
(Optional)
Select An Option
African American
Caucasian
Native American
Hispanic
Asian/Asia-Pacific
More than one race
Other
Age Range
(Pick one)
Select An Option
Below 18 years old
18-24 years old
25-35 years old
35 or older
Personal Pronouns
(Pick one)
Select An Option
She, Her, Hers
He, Him, His
They, Them, Theirs
I'd rather not say
Professional Background Information
Years of experience
Select An Option
Early level (0-5 years)
Mid-level (5-10 years)
Senior level (11+ years)
Do you currently hold any HR Certifications?
(Check all that apply)
None
aPHR
PHR
SPHR
SHRM-CP and PHR
SHRM-SP
Other
What are your HR areas of expertise?
(Check all that apply)
Generalist
Talent Acquisition/Recruiting
Total Rewards, Compensation & Benefits
Risk Management
Human Resources Information Systems (HRIS)
Employee & Labor Relations
Learning/Training and/or Organizational Development
EEO, Diversity & Inclusion
Compliance
HR Consulting
Other
Current Employer / Job Title / Dates of Employment (Month-Year to Month-Year)
0
/
Previous Employer / Job Title / Dates of Employment (Month-Year to Month-Year)
0
/
Previous Employer / Job Title / Dates of Employment (Month-Year to Month-Year)
0
/
Previous Employer / Job Title / Dates of Employment (Month-Year to Month-Year)
0
/
Please attach your resume'
pdf or word only
cloud_upload
Upload Files Here
How many hours can you commit to mentorship?
(Pick one)
Select An Option
1-3 hours per week
1-3 hours per quarter
1-3 hours per month
What are you hoping to contribute to the mentorship program?
0
/
100
Please check any areas in which you would like to see self-improvement.
None
Increased confidence in public speaking skills
Enhanced confidence in the professional world
Learn how to network; define networking strategies
Increased exposure to a job or field
Get advice from professional in field of interest
Acquire feedback regarding my strengths and/or area for improvement
Enhanced understanding of how to integrate interests and experience
Gain insight into the lives of business professionals
What are you hoping to gain from the mentorship program?
0
/
100
By submitting this application, I agree that (if accepted into the program) I will take initiative, act in a professional manner, and be respectful of time commitments.
I agree to the above and acknowledge that all information submitted is correct to the best of my knowledge.
Submit Application
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