Mentor Registration

Mentor Registration Form Fall 2024

General information

Participant's name*

LinkedIn Profile URL*

Address*

Phone*

Email*

Chapter Member? Yes/No*

Experience and interests

Current Title*

Years of experience in project management*

Current Employer*

PMP Certified? Yes/No*

In which industry are you currently working*

Other industries in which you have experience*

Have you ever participated in a mentor program? if yes, share your experience.*

Interests/Hobbies*

Mentorship program in which you want to participate

Project Management Skills

Leadership

Career Development

Availability (preferred mode of communication, time of the day)*

I would like to work with a Mentee on? ex Processes, Tools and Techniques, Leadership Skills, Scope, Cost or Time Constraints, Open to all, etc.**

Which experience(s) are you bringing to the mentor relation*

Why do you wish to participate in the mentor program?*

What are the objectives that you would like to achieve by participating in the mentor program?*

Other information that may be pertinent to the processing of your application*

Maximum number of Protègè

1 - 4