Print out Mentor and Mentee Application Forms


MENTORING PROGRAM FOR ACADEMIC PROFESSIONALS AND
FACULTY INTERESTED IN ADMINISTRATION

MENTOR APPLICATION

Name:_______________________________ Title:_______________________________

 

Department:__________________________ College:_____________________________

 

Campus Location: East Side West Side

Telephone:___________________________

 

Fax:__________________________________ E-Mail:_____________________________

 

Total years employed at UIC? ______________

 

Please rank the following ten items from 1 - 10 (using each numerical value only once) to indicate what you would be able to best provide for a mentee with 1 = best able and 10 = least able to.

_______ strategies for career advancement

_______ networking to increase exposure for potential career opportunities

_______ effective negotiation of political environment

_______ role modeling for position and academic culture

_______ provide professional support by being a sounding board

_______ developing interpersonal connections

_______ career path planning

_______ assist in the identification of blind alleys and stumbling blocks to advancement

_______ helping mentees' to better articulate and realize their dreams

_______ providing constructive feedback and skill building

 

 

Would you be interested in participating in training programs aimed at supporting and developing the mentors? Yes No

Check the time(s) that you would be available for training?

8:00-9:00am 9:00-10:00am 12:00-1:00pm 4:00-5:00pm 5:00-6:00pm

Check what day(s) would be best for training?

Monday Tuesday Wednesday Thursday Friday

As a Mentor would you attend training sessions in the following areas:

Active Listening Skills: Cornerstone of the Mentoring Relationship Yes No

How to Give Effective Feedback Yes No

Communication and Team Building Across Personality Styles Yes No

 

Other Suggested Topic Areas: ___________________________________________________

 

Signature: _______________________________ Date:_______________________


Return completed forms to by May 15, 1999
Rebecca Gordon
Office of Women's Affairs (MC 363)
Phone: 413-1025 Fax: 413-8393
rebeccag@uic.edu

 

 

MENTORING PROGRAM FOR ACADEMIC PROFESSIONALS AND
FACULTY INTERESTED IN ADMINISTRATION

MENTEE APPLICATION

 

Name:_________________________________ Title:_______________________________

 

Department:____________________________ College:_____________________________

 

Campus Location: East Side West Side

Telephone:___________________________

Fax:__________________________________ E-Mail:_____________________________

 

Total years employed at UIC? ______________

Are you a faculty menber interested in moving into administration? Yes No

Please rank the following ten items from 1 - 10 (using each numerical value only once) to indicate what is most important for you to receive from your mentor with 1 = most important and 10 = least important.

_______ learning strategies for career advancement

_______ networking to increase exposure for potential career opportunities

_______ effective negotiation of political environment

_______ role modeling for position and academic culture

_______ professional support by being a sounding board

_______ developing interpersonal connections

_______ career path planning
_______ assistance in the identification of blind alleys and stumbling blocks to advancement
_______ help articulating and realizing career dreams

_______ obtain constructive feedback and skill building

 

Briefly describe your career goals? ___________________________________

__________________________________________________________________________

__________________________________________________________________________

Would you be interested in participating in training programs aimed at supporting and developing the mentees? Yes No

Check the time(s) that you would be available for training?

8:00-9:00am 9:00-10:00am 12:00-1:00pm 4:00-5:00pm 5:00-6:00pm

Check what day(s) would be best for training?

Monday Tuesday Wednesday Thursday Friday

Would you attend training sessions in the following areas:

Making Mentoring Work for You Yes No

Career Exploration Yes No

Communication Across Personality Styles Yes No

Other Suggested Topic Areas: ___________________________________________________

Signature: ______________________________ Date:_______________________


Return completed forms to by May 15, 1999
Rebecca Gordon
Office of Women's Affairs (MC 363)
Phone: 413-1025 Fax: 413-8393
rebeccag@uic.edu

Take Me Back to the Office of Women's Affairs Home Page