Enrollment Form: The Shansi Alumni Mentorship Program

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Name

Pronouns

Preferred Email

In which Shansi Site did you work? During which years?

How would you like to participate in the Shansi Alumni Mentorship Program? (Select all that apply)

I would like to be included in the Alumni Directory.

I would like to be considered for online career panels and professional development workshops.

I am a current Fellow/recent alum and would like to participate as a mentee.

In which city and state are you based?

What is your current position and the name of the organization for which you work?

In which career sector/industry do you work? Do you have significant experience or expertise in other sectors/industries? If so, please list them below.

Please list any degrees or professional certifications you've earned after the Fellowship. (Please include the granting institution.)

Are you affiliated with any other organizations or professional associations? This might include previous organizations for which you have volunteered or served as board member.

(Optional) Please provide a brief personal bio about your career, areas of expertise, and/or interests. (Less than 75 words.)

(Optional) Please provide a link to your LinkedIn profile.

If you indicated interest in participating in a career panel, we may contact you if we host a session on your field/sector. If you are interested in a skills-related workshop (i.e. resumes vs CVs, interview tips, personal statement writing) please let us know. What type of workshop could you host?

Thank you! If you have any questions about the program, feel free to email Ted Samuel (tsamuel@oberlin.edu).

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