Bridge Mentorship Mentee Application 2021-2022
This mentorship program is for adult immigrants and refugees who are looking for career development.
Please email bridgementorprogram@gmail.com with any questions.
We look forward to reviewing your application!
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Personal Information
Full Name *
Full Address *
Email Address *
Phone Number *
Date Available to Begin Program *
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Status
Are you legally eligible to work in the US? *
Have you ever worked in the US? *
If yes, when & where?
Have you ever been convicted of a felony? *
If yes, please explain:
Do you use Medicaid/Medicare? If not, what health insurance do you have? *
Education
High School Name & Location
Dates you Attended High School
College Name & Location
Dates you Attended College
List any Degrees or Certifications you have earned:
What are your future Education Goals if any: *
Languages
Language(s) you speak and what level (fluent, proficient, basic, etc) *
Languages you can read/write: *
Language goals, if any:
Previous Experience/Employment
Employer 1 Name:
Employer 1 Email
Employer 1 Phone Number
Employer 1 Location
Position Title and Responsibilities *
Dates Worked
Employer 2 Name
Employer 2 Email
Employer 2 Phone Number
Employer 2 Location
Position Title & Responsibilities
Dates Worked
Skills You Currently Have: *
Skills You Would Like to Learn: *
Goals
What Field Do You Want to Build a Career in? *
What position or job would you like to hold in the future? *
What are your long-term career goals? *
Where do you see yourself in three years? *
Is there anything you would like the Bridge Program to know about you or are there any accommodations you need during this process? Let us know here!
Disclaimer: Applicant understands that this application does not guarantee a mentor pair or a position in their field of choice. This program and this application is not a guarantee of a job. If selected, applicant agrees to stay committed to the program and follow through on mentee responsibilities in order to meet professional and personal goals.                                          I, the Applicant, certify that my answers are true and honest to the best of my knowledge.  Type your name to sign your certification. *
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