PACSW Women's Mentoring Program Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in applying to be a participant in the PACSW women's mentoring program. The program will run from August 2022 and conclude in December 2022.

Together mentors will explore ways to increase professional and personal capacity, connect with the USF community, and develop confidence.

Any woman-identified employee of the University of San Francisco is eligible to participate in the program, regardless of employee class, status, or title.

Please complete the following application to participate in the program by JUNE 03, 2022.

If you have any questions, please contact pacsw@usfca.edu.

Email *

Name *

Title *

Divisional Area *

Years at USF *

Age

Are you interested in being a mentor, mentee or both? *

Mentor

Mentee

Either

Please confirm you will be available to your potential co-mentor monthly between the months of August and December 2022. Mentor pairs will be able to decide if they want to meet remotely or in-person. *

Yes, I will be available

What is your preferred modality for the mentorship program? We will strive to match participants with a co-mentor with a similar preference but can't guarantee it.

I can meet only remotely

I prefer remote, but I can meet in-person

I prefer in-person

I have no preference

Clear selection

In addition to monthly meetings with your partner, please confirm you will be available to attend the following required, mentor program events. Events will be held in a hybrid format with remote or in-person attendance options available. We will ask each mentor pair to coordinate how they plan to attend. *

Program Kick-off / Training (September 7, 2022 - 12-1:30 pm)

Mid Semester Check-In (October 12, 2022 - 12-1:30 pm)

Program close (December 7, 2022 - 12-1:30 pm)

Required

We will endeavor to match mentors and mentees based on specific characteristics each are seeking. (Please check all of the following which apply to you.) *

Athlete

Visual or Performing Artist

Commuter

Employee who has cared for a non-child family member

Employee with a disability

Enrolled in a program of study

Experience with academic promotion

Experience with professional staff promotion

Experience taking career breaks

LGBTTQ+

BIPOC (Black/Indigenous/Person of Color)

Parent of a young child (child/children under 10 years of age)

Parent of tween/teenager (child/children between 11-19 years of age)

Parent of an adult child (child/children 20+ years of age)

Staff

Faculty

Executive/Leadership Position (i.e. Dean, Associate Dean, Vice Provost, Program Director, Director, Manager)

USF Grad

Work full time

Work part time

Other:

Required

Which of the following themes would you be interested in providing or receiving co-mentorship around. (Check all that apply.) *

Navigating the university

Leadership and management

Work life balance

Professional growth and interpersonal skills

Academic career advancement (if applicable)

Diversity Equity and Inclusion

Required

What is your motivation for participating in this program? *

Have you applied to be part of the PACSW Women's Mentoring Program before? *

Yes

Have you participated in the PACSW Women's Mentoring Program before? *

Yes

Is there anything else you'd like us to know? *

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Faculty and Staff DonsApps. Report Abuse

Forms