Mentor Application

Please complete the form below to be considered as a potential mentor for the Converge mentorship program. Converge will review your application and coordinate an interview to determine your eligibility.

Must reside in North America.

Mentor Application

Headline

e.g. Sales Manager at Acme

About Me

Please write a short bio about yourself.

Country

City

First Name *

Last Name *

Mobile

Email *

Areas of Mentorship Advancement

How many years of experience do you have in your business function?

Must have a minimum of 5 years experience.

Information Technology Role

Employment Status

Employed

Unemployed

Retired

Business Function

What are your top 3 goals for mentorship engagement?

LinkedIn Profile

Add a link to your LinkedIn profile to share with your mentees.

By checking the box below you agree to the following terms:

1) Communication - Mentors/Mentees exchange cell phone numbers and email addresses (work or personal). 
2) Discussions are confidential; mentorship environments are a safe space.
3) Touchpoint with Program Lead – schedule time with the Program Lead 30 days after program starts.
4) Program Update - Provide monthly progress updates.
5) Impact - Complete Final Report. 
6) Process Improvement - Provide constructive feedback to mentor and mentee program lead.
7) Participation in this program is not a promise or guarantee of an employment offer.

Are you open to supporting two mentees in a single cohort?

Yes

If you are human, leave this field blank.