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Mentee Questionnaire

To take advantage of our Mentor Matching service, you must become a member. Afterwards, please complete the following form. The information you provide is used to match you as closely as possible with the right mentor.

Name

E-mail

City, Prov/State

Country

Describe your current need for a mentor.
(ie. help with; marketing or sales, assertiveness, administration, etc.)

Describe why you want to be mentored.    

What benefits do you expect the mentorship will provide?

Describe the benefits that you will bring to the mentorship relationship?

Describe any mentoring experiences you have had, if any.

What do you look for in a mentor?  What specific skills, attitudes, etc., do you want your mentor to possess?

If your mentoring relationship works, what in your opinion would be the achieved outcomes?

How do you want to communicate with your mentor? (ie:, e-mail, telephone, chat, fax, etc.)

What is your preferred language?

English French Other

Do you have a preference of gender for your mentor?

Female Male Doesn't Matter

What frequency would you require contact with your mentor?

Once per week Once per month Twice per week Twice per month Other
If Other, specify

Please add any additional comments.

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