Baylor Entrepreneurship Mentor Program
Date Submitted: __________________
Mentor Application
Name: ______________________________________________________________________________
E-mail: ______________________________________________________________________________
Address: ____________________________________________________________________________
Best Phone Number to Use: _____________________________________________________________
Title: _______________________________________________________________________________
Company Name: ______________________________________________________________________
Website(s): __________________________________________________________________________
Type of Business/Industry: ______________________________________________________________
In what city are you based?
________________________________________________________________
University Degree(s) and Name of University Attended: ______________________________________
Where did you grow up? _______________________________________________________________
With what types of businesses have you been involved?
___________________________________________________________________________________
Please tell us about your entrepreneurial activities? ________________________________________
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Why are you willing to be a Mentor? ______________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What are your expectations of the Mentor Program? ________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
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What other information do you think important to relate? _____________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
If you agree to the following, please initial in the blanks:
__________ Provide the student with the best way, time and day to communicate with you
__________ Communicate with the student in the manner, frequency, date and time agreed upon with
the student
__________ Be sensitive to the needs of the student and recognize when support, assistance or
independence is needed
__________ Let the program advisor know if communication is not taking place between mentor and
student or if there is some other challenge that requires the program advisor’s assistance
__________ Share your personal thoughts about the benefits of the mentoring program and any next
steps
________________________________________
Signature
_______________________________________
Date
Please pdf and e-mail this application to Amy Easley, Program Manager of the
Entrepreneurship Mentor Program, John F. Baugh Center for Entrepreneurship, Suite
#301, Hankamer School of Business, Baylor University. If you have any questions, Amy can
be reached at 254.710.4290 or Amy_S_Easley@baylor.edu. THANK YOU.