EMPower Mentor Application
Please provide the following contact information:
Applicant’s Name: ______________________________________________________________
Address: ______________________________________________________________________
Telephone: ____________________________________________________________________
Email: ________________________________________________________________________
Social Media: __________________________________________________________________
Preferred method of contact: Telephone_____ Email _____ Social Media _____
Becoming a Native American STEM mentor represents the beginning of a powerful journey.
Many mentors/mentees end up forming relationships that last far beyond the mentoring
experiences. They often become friends, allies, and lifelong colleagues in STEM. The mentoring
experience for Native Students is often different than that of mainstream students. The values
orientation of Native students is sometimes subtly and sometimes dramatically different than
that of the University. Research and experience has shown that those who have navigated these
challenges themselves are best suited to assist others. The STEM fields also present their own
unique challenges and opportunities for Native students. The challenges are often easy to see
while the opportunities may appear unclear, distant or even invisible. Assisting other students in
navigating these challenges is rewarding.
These considerations make this a somewhat “different application”. We pay special attention to
“the match” of mentor and mentee. Tribal, social, cultural, leadership and communication styles
are a few of the factors we use. Please answer the questions to the full extent you are
comfortable. Being is specific helpful. Completing this application represents your desire to help
other students.
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EMPower Mentor Application
To help facilitate an effective mentor/mentee match please respond to the following:
1. Reason(s) for wanting to be a mentor:
2. Provide a brief summary of your relevant experience: i.e. education, work, experience,
specialized skills, etc.
3. Is there a particular area field of study you would most like to work on with a mentee? If
so, please provide details:
Time Requirements:
4. We require one hour each week to be set aside to meet with your mentee. Time spent
outside of this requirement will vary according to the needs and desires of each
mentor/mentee pair.
Is it possible for you to provide this time for the program? Yes____ No____
5. Along with the requirement to meet with your mentee weekly, there will be a mentor
training that will take place within the first month of becoming a mentor. This training
generally lasts a half day and lunch is provided. This training will not interfere with your
class schedule and is generally planned for a weekend day.
Is it possible for you to provide this time for the program? Yes____ No____
*Once a month in October and November we will have a guest speaker or skill building
event and we ask that you please attend. These meetings take place in the evening and
dinner is provided. In the instance that you have little ones, they are always welcome.
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EMPower Mentor Application
6. The EMPower mentoring program will try to match mentors with mentees of a similar
background if requested.
Which tribal group/communities/traditions/cultures do you have the most experience
with?
Which tribal language(s) do you have the most familiarity with?
7. What characteristics would you be looking for in a mentee?
8. Please share any additional thoughts, comments or recommendations. Thank you.
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EMPower Mentor Application
In order to achieve the best match for mentor and mentee we ask you to fill out the following
communication and cultural values survey. All the answers are a continuum and there is no
right or wrong answer. Please place an X nearest the value you share or answer that best
represents your feelings, experiences or views.
INDIVIDUAL FREEDOM \__ __ __ __ __ __ __/ GROUP CONSENSUS
DIRECTNESS \__ __ __ __ __ __ __/ POLITENESS
FAMILY OR COMMUNITY FINANCIAL SECURITY \__ __ __ __ __ __ __/ PERSONAL FINANCIAL SECURITY
LISTENING SILENTLY \__ __ __ __ __ __ __/ SPEAKING FORCEFULLY
CHARGING AHEAD \__ __ __ __ __ __ __/ MOVING WITH A GROUP
SUPPORTIVE FAMILY \__ __ __ __ __ __ __/ SUPPORTIVE COMMUNITY
PREPARATION FOR THE FUTURE \__ __ __ __ __ __ __/ BEING IN THE MOMENT
TRIBAL IDENTITY \__ __ __ __ __ __ __/ INDIVIDUAL IDENTITY
FAMILY \__ __ __ __ __ __ __/ DETERMINED BY BIOLOGY FAMILY DETERMINES BY KINSHIP (CULTURE)
WISDOM \__ __ __ __ __ __ __/ KNOWLEDGE
CALMNESS \__ __ __ __ __ __ __/ EXCITABILITY
QUIETNESS \__ __ __ __ __ __ __/ LOUDNESS
LEARNING BY OBSERVATION \__ __ __ __ __ __ __/ LEARNING BY DOING
NATURAL SPACES \__ __ __ __ __ __ __/ URBAN SPACES
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