Name: ZABS Place
Price range: $

Name:*

Email:*

Job Title:*

What do you like most about your current position or company?*

How do you spend your time outside of work? What are some of your hobbies, interests, volunteer work, or community activities?*

Do you have any experience interacting with differently-abled individuals?*

Great! We'd love to learn more about it.*

Have you been a Mentor before?*

Great! Can you tell us more about it?*

What motivated you to participate in our Mentorz program?*

How much time are you able to commit to a Mentorship?*

What type of commitment did you have in mind?*

What days are most convenient for you to meet?*

Which of these meeting times work best for you?*

As a Mentor, how comfortable are you helping your Mentee with:*

	Comfortable	Open to it with Guidance	Hesitant	Uncomfortable
Career advancement skills?
Building leadership skills?
Discussing appropriate workplace behavior?
Offering advice about what to do in specific situations? (i.e. resolving conflicts, building confidence in & out of work.)
Reviewing skills relevant to Mentee's line of work?
Building a professional network?

In what other ways would you like to help your Mentee?*

What else would you like us to consider when assigning you a Mentee?*

	Best Time	Would be Ok	Not Great	Doesn't Work
Mornings
Noon
Afternoon
After Work
I'm flexible with advanced notice

ZABS Mentorz Application Form