NAHN Unidos - 2022 Mentee/Mentor Application

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Thank you for your interest in the National Association of Hispanic Nurses (NAHN) Phoenix Chapter’s Mentorship Program! We are excited to create a program that will help strengthen NAHN’s values and help exemplify nursing leadership. The objective for development of NAHN Unidos was to help develop and strengthen leadership through collaboration and famialismo. Through this voluntary program, participants will be paired up in order to strengthen personal and professional skills, to identify and achieve both short- and long-term goals, and to help achieve NAHN’s mission. This mentee-mentor relationship requires commitment and mindful planning in order to be beneficial for all members. As such, the program will revolve around activity sessions planned throughout the year. Each mentee and mentor will create a plan consisting of: short- and long-term goals, developing an agreement which delineates the method and frequency of communication and/or meeting sessions, and determination of activities that can be done during each session.

Completion of the participation survey must be completed by Friday, July, 1st in order to be considered for the NAHN Unidos Mentorship Program. If you have any questions, please don’t hesitate to contact the Community Outreach Chair at NahnVolunteers@gmail.com.

To help out with the paring process. Please fill out this questionnaire. Answer each question as thorough as you can.

** Membership is required to participate **
**To view the NAHN Unidos mentorship packet PDF, please visit our website at https://nahn-phx.org/nahn-unidos-mentorship

What is your full name? *

What is your phone number? *

What is your email address? *

What is your zip code (estimate distance between mentee/mentor) *

Are you looking to be a mentee, mentor, or both? *

Mentee

Mentor

Both

Are you a member? *

Yes

Are you a nurse? If so, where do you currently work? What unit? How many years have you worked as a nurse? (leave blank if not applicable)

Are you currently in school? If so, what School? What block are you in? (leave blank if not applicable)

What drives you to be a nurse? *

What attributes or skills would you want to emulate as a nurse? *

What area(s) of nursing most interests you? If undecided, what areas would you be interested in learning about? *

What accomplishment(s) are you proud of (either professionally or personally)? *

Have you been or had a mentor/mentee before? If so, what were some of the benefits? What do you hope to gain from this mentorship program?

What are three strength and three weaknesses that you believe would impact your ability to be the nurse you want to be? *

What are you interests/hobbies, or anything you want us to know about you?

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