Mentee Application Name(Required) First Last Email(Required) Phone(Required)Chapter(Required)State(Required)What time zones are you comfortable working in? Eastern Central Mountain Pacific Hawaii Years of Membership(Required)Please enter a number from 0 to 22.Current Leadership RoleWhat are your primary goals for participation in the MILE mentorship program? (check all that apply)(Required) Leadership Development Public Speaking & Communication Career Advancement Community Engagement & Advocacy Conflict Resolution Networking & Professional Growth Personal Development Other Specify your Other primary goal for participationWhat specific skills or areas of improvement would you like your mentor to help you with?(Required)What are your long-term leadership or career aspirations?(Required)Do you have a preferred mentor? If yes, please list their name:How would you like to be matched with a mentor? (check all that apply)(Required) Based on leadership goals Based on professional background Based on shared interests or experiences Other Specify your Other way you would like to be matchedWhat’s your preferred mentorship format? (Select all that apply)(Required) Phone Virtual (Zoom, Google Meet, Teams, etc.) In-Person (where applicable) Hybrid (mix of Virtual and In-Person) Email / Text How many hours a month are you willing to take to communicate with your mentor?(Required)Please enter a number from 0 to 20.Are you willing to complete periodic surveys or feedback forms to help improve the program?(Required)YesNoThird ChoicePlease provide any other relevant details that would help us match you with the best mentor.
