Mentor Registration Form

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2015-2016 Mentor Program Registration
Be a Mentor – Make a Difference!
Program Description
The School of Business Mentor Program provides students with an invaluable opportunity for
personal and professional development through the support of a mentor.
Mentors provide guidance and support to help students to: enhance their knowledge and skills; build
their self-confidence; explore and better define their career goals and options; and, build their
professional network. As a mentor you can share your background and career experiences, impart
industry trends and best practices, and give professional advice relevant to the student’s career
interests and goals.
Each mentor is assigned to one student (aka mentee), who is attending a campus that is within
reasonable proximity of the mentor’s regional area.
Participation Requirements for Mentors
All Mentors selected for this program are required to:

Complete and submit the Mentor Registration Form, a current Resume, and all required
documentation by August 7, 2015.

Attend the Mentor Program Orientation & Mixer on October 17, 2015 at the Redlands campus.

Plan and meet with your assigned student/mentee in-person once per month at a minimum for
the duration of the seven-month program.

Utilize mentoring resources and support available.

Provide informal updates on your progress.

Attend the Mentor Program Closing Ceremony on May 14, 2016 at the Redlands campus.
Mentor Registration and Participation Requirements
Part 1:
Mentor Registration Form (page 2)
Part 2:
A copy of your current Resume
Part 3:
Mentor Participation Agreement (page 3)
Part 4:
DISC Personality Test
Please complete the free online DISC Personality Test. Then, print and submit your results.
To access the test, visit: http://discpersonalitytesting.com/free-disc-test/.
Page 1 of 3
Part 1: Mentor Registration Form
Name and Contact Information
First Name:
Last Name:
Street Address:
Cell Phone#:
Email Address:
City:
State/Zip:
Work/Alternative Phone#:
Employment Information and Areas of Expertise
Current Employer:
Title:
Please indicate the area(s) you currently have oversight of or possess experience in:
IT
Accounting
Operations
International/Global Business
GIS
Marketing
Sales
Finance
HR
Public Admin.
Development
Other:
Do you have any Mentoring experience?
Yes, with U of R
Yes, for work/other
No
Do you have any Mentoring preference?
Graduate
Undergraduate
No
Are you a U of R Alumnus?
Yes, my degree is:
No
The Mentor Registration form, Resume, and supporting documents are due by August 7, 2015. For
consideration, please submit all materials to Christine Taitano, the Director of Student Services, at:
Christine_Taitano@Redlands.edu.
Individuals selected to be mentors in the Mentor Program must attend the Mentor Program
Orientation & Mixer (Saturday, October 17, 2015), meet with assigned student/mentee in-person
once per month at a minimum for the duration of the seven-month program, and attend the Mentor
Closing Ceremony (Saturday, May 14, 2016). All Mentors will receive an orientation at the Orientation
and Mixer in October. Following the orientation, mentors will be introduced to their assigned
student/mentee.
I accept the terms of participation in the University of Redlands School of Business Mentor
Program. I authorize the sharing of my personal contact information & Mentor Program application
materials with my assigned student/mentee.
Signature:
Date:
FOR MENTOR PROGRAM COORDINATORS USE ONLY
 Mentor Registration  Resume  DISC Personality Profile  Mentor Participation Agreement
Mentee: __________________________________________________________________
Page 2 of 3
2015-2016 Mentor Program
Mentor Participation Agreement
By signing below, I understand that as a participant in the Mentor Program, I must actively
participate and commit to all of the following events and activities:
 Attend the mandatory Mentor Program Orientation & Mixer- scheduled on Saturday,
October 17, 2015, from 9:15 a.m. – 12:30 p.m. at the Casa Loma Room, Redlands
Campus.
 Plan, schedule, and attend all in-person mandatory meetings with my mentee (once per
month at a minimum) from October 2015 to May 2016.
 In addition to monthly meetings, follow through with all scheduled activities and
communication (emails, calls, etc.) with my mentee throughout the seven-month
program.
 Provide informal updates on my progress with mentee, and notify the program
coordinators immediately if there are any extenuating circumstances that might prevent
me from meeting with my mentee or may delay my follow through with any activities
 Utilize mentoring resources and support available.
 Notify my Master Mentor and/or the Student Services staff if I am experiencing difficulty
contacting or working with my mentee.
 If schedule permits, actively participate in the Regional Alumni Chapter Mixer events and
Employer Site Visits.
 Attend the mandatory Mentor Program Closing Ceremony - scheduled on Saturday, May
14, 2016 from 9:15 a.m. – 12:30 p.m. in the Casa Loma Room, Redlands Campus.
I acknowledge and understand that as a Mentor, I must fulfill the duties and responsibilities
outlined in this agreement.
Print Name
Date
Signature
Page 3 of 3
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