Mentor Application Questions
Thank you for taking an interest in our mentorship program.  We very much appreciate your willingness to become a mentor in our program.  We will do our best to appropriately match you with a mentee based on how you answer the questions below.  However, there is no guarantee that we'll be able to match you with a mentee depending on the number and the specific needs of persons seeking a mentor.      

All information provided on this form will be held in confidence and will only be seen and reviewed by SEAPAX board members who serve on our Mentorship Committee.    

We will contact you to provide an update on your application as soon as possible.  
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Name *
Email Address *
Cell Phone Number if Available *
Preferred Contact
Clear selection
Current Location (city, neighborhood, or town)
Gender (Optional)
Sexual Orientation (Optional)
Ethnicity/Race (Optional)
Birthdate
College Degree(s)
Current Employer *
Current Job Title *
What current job sector do you work in? *
Country(ies) and Year(s) of Service *
PC Sector(s) *
General Interests (Mark all that apply) *
Required
On a scale of 1-5 (1= low, 5 = high), please rate your level of mentoring expertise in the following areas: *
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2
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4
Column 5
Finding Housing
Job/Career Help/Professional development
Social networking/events
Reintegration/Readjustment
Grad School
Service/Volunteer Opportunities
Navigating Seattle
To talk about PC experience
Other
On a scale of 1-5 (1 = not important, 5 = very important), please rate the following characteristics you'd want in a mentee: *
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2
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5
Same sex/gender
Similar age
Similar professional background/interests
Served in the same PC country/region
Similar general interests
Familiarity with Seattle
Similar PC sector
Please list any other information that you think would be relevant for us to appropriately match you with a mentee (the more information provided the better we can match you with a mentee):
What would you like to get out of the mentorship program (the more information provided the better we can match you with a mentee)?
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