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Leadership
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Bylaws
Contact Us
Join
Membership Benefits
Types of Membership
Publisher
Associate
Affiliate – Company
Affiliate – Individual
Charlie Awards
2023 Charlie Awards
Past Winners
Scholarship
Donate
Scholarship Application
Events
Sponsorships
Calendar
Annual Conference
Past Conferences
Members
Login
Peer Mentorship Program
Job Board
Member Directory
Associate Member Directory
Affiliate Member Directory
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Scholarships
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Mentorship Application
Full Name
*
Phone Number
Email Address
*
Are you applying to become a (check all that apply)
*
Mentor
Mentee
Please state why you are applying to the program :
*
What is your preferred method of participating in the program (check all that apply):
*
By phone
Virtually (Zoom, Teams, Skype, Google Meet, etc.)
In person (Please note that we may not be able to pair you with a mentor/mentee in your area)
No preference
Please take a moment to read the
“Peer Mentorship Program Code of Conduct”
Do you agree to follow the Code of Conduct while participating in the program (check one):
*
Yes
No
Complete only if applying to become a Mentor:
Please indicate your areas of specialization so we can best match you with a mentee:
Are you able to commit to a minimum six-month volunteer mentorship period (check one):
Yes
No
SUBMIT FORM
