Mentee Application

Please complete this form if you wish to enter into a mentoring opportunity.
First Name
Last Name
Work Phone
Gender (optional)
Ethnicity (optional)
Year became Lobbyist
Current Employer
Preferred Contact Address:
City State Zip

Lobbying Area(s):

Below are some of the common goals of our mentees. Please help us match you with an appropriate mentor by rating how important the following characteristics and goals are for a mentoring relationship.
(using a sacle of 1=Important to 3=Not Important
  Same Ethnicity
  Same Gender
  Same Lobbying Area (Association/Independent/Non Profit)
  Receiving advice on business advice and developing contacts in the statehouse community
  Receiving advice on client relationships
  Receiving advice on work-life balance
  Receiving assistance with assessing career path and options
  Receiving feedback from your Mentor
  Other (Please Specify)
   - denotes required fields