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Virtual Mentorship Program Interest Form
Thank you for your interest in participating in the Bhutanese-Nepali Mentorship Program Pilot Project. Please fill out the survey below so we can get in touch with you with further details.
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* Indicates required question
Email
*
Your email
Name (First and Last)
*
Your answer
Phone Number
Your answer
Age (eg. 16)
*
Your answer
What gender do you identify with?
*
Female
Male
Non-binary/third gender
Prefer not to say
Other:
Pronouns
*
he, him, his
she, her, hers
they, them, theirs
Other:
Which of the following best describes you?
*
High School Student
College Student
Recent Graduate
Working Professional
If working professional or college student, please indicate your college major. If high school student, please indicate your career or major interest.
*
Your answer
If working professional, please indicate your current employer.
*
Write N/A if not applicable.
Your answer
Which role are you interested in?
*
Mentor
Mentee
Have you ever participated in a mentorship program before?
*
Yes - as a mentor
Yes - as a mentee
No
Realistically, how much time can you invest in the mentorship program?
1-2 hours per week
1-2 hours biweekly
1-2 hours per month
1-2 hours per semester
Clear selection
Insert your LinkedIn profile
Your answer
If you know anyone who would be a good fit for the program, please provide their name and contact information.
Your answer
A copy of your responses will be emailed to the address you provided.
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