I will attend the Mentor Orientation/Kick-off on Friday, September 20, 2013, from 6:00 - 8:00 p.m. 

Yes
No
Uncertain

Biographical Information

Please list your degrees.

What was your first job after you finished school and how did you find it?

Please tell us a little about your career path and any significant professional memberships?

What do you do in your current job?

Areas of interest for the Ancell Mentor Program (select all that apply)

Accounting
Banking
Consulting
Corporate Finance
E-Business
Education
Engineering
Entertainment
Entrepreneurship
Financial Services/Investments
Government
Healthcare
Hospitality
Human Resources
Information Technology
International Business
Management
Manufacturing
Marketing
Operations Management
Public Service
Real Estate
Retail Management
Sales
Other

Mentor’s Agreement

By submitting this application you acknowledge and accept the following:

1. You have read and agreed to your roles and responsibilities as a Mentor.
2. Your behavior will be ethical, professional and responsible at all times.  Specific details discussed will be kept confidential.  You should contact the Mentoring Coordinator if you feel uncomfortable with your Mentee’s behavior or are concerned about their safety.
3. WCSU takes no responsibility for the behavior of participants, nor for any advice or information exchanged between you and your Mentee.
4. Your name, phone number, email address and employment details will be made available to your Mentee. Mentees are asked to hold all information about you in strictest confidence.
5. In the event that you invite your Mentee to visit your workplace, you must advise him/her of relevant occupational health and safety procedures.
6. You must not offer or accept any monetary remuneration as a result of the Mentoring Partnership.  If an opportunity for work experience for your Mentee arises, you must notify the Mentoring Coordinator. You must also comply with relevant legal and operational employment policies and procedures.

What happens next?

The Mentor Program Coordinator will contact you to advise you on whether there is a registered student to suit your profile.

You are invited to attend the Mentor Orientation/Kick-off Reception.

Thank you!  We look forward to working with you this year!

If you have any questions about the Ancell Mentor Program, please contact Elise Silkowski.
via phone:  203-837-8567 or email: silkowskie@wcsu.edu