mentoring-application07

Mentoring - 2007 Mentee Application

Click here to download Mentee application

Date:
Name:
Title:
Organization:
Business Address:
Business Phone Number:
Fax Number:
Cell Phone:
Email Address:
Your Manager's Name:
Your Manager's Title:
Your Manager's Phone number:
Your Manager's Email Address:

Please answer all of the questions below:

1. Why are you interested in being mentored? What do you hope to learn?

2. What personal and professional objectives do you hope to achieve through the mentoring process? Consider your past performance reviews and feedback you have received from others, as well as your career goals. List at least three specific objectives.
Example Objective: My current role requires that I have more technical business knowledge. I would like to learn more about the technical side of telecomm and acquire an understanding of how I can further develop in this area.
Example Objective: I need to increase my level of communication at meetings with senior executives as I tend to be quiet and not speak up – and often my ideas don’t get approved.
Example Objective: I was recently promoted into a position that has direct reports – which I have not had in the past. I want to understand what I need to do to be a successful manager of employees – especially in the area of delegation.

3. What qualities are most important to you in a mentor?

4. Please review the mentors’ profiles and indicate those that you would be most interested in being mentored by – those that you think would be a “best fit” with your developmental objectives listed above. Mentees will be assigned to mentors based on developmental interests on a first come, first served basis. Please mark only three choices from below. Mark those choices with an X.

Name	Title	Company	3 Choices Mark w/ X
Morag Barrett	President	Skye Associates LLC
Richard Buchanan	VP, Operations	Comcast Media Center
Cynthia Carpenter	VP, Marketing	Level3 Communications
Heidi Hollenbeck	Sr Director, Voice Operations	Comcast Cable Corporation
Rebecca Lim	Sr Director, Advanced Services	Starz Entertainment, LLC
Jacyn Meyer	Affiliate Sales Director	Starz Entertainment, LLC
Michael Turner	Vice President, Communications and Content	Hitachi Consulting
Katy Uhl	VP, Human Resources	Comcast Cable Corporation

5. What kinds of people would you most like to be mentored by (e.g., someone in the same functional area, individuals in the same company, individuals at a specific level in the organization, individuals with similar career paths, etc.)?

6. Are there any restrictions on the types of people you would not want to mentored by (e.g., competitor employees, employees in the same company, individuals below or above a certain professional level, individuals working in a certain function, personality types, etc.,)?

7. Please answer the following questions concerning your job experience.

a. Years of work/business experience:

b. Years of cable/telecomm experience:

c. Are you an individual contributor (do not have direct reports)

d. Are you a first level supervisor with direct reports –

e. Are you a manager with direct reports –

f. Are you a director with direct reports –

g. Are you a VP or above with direct reports –

h. If you manage direct reports, how many years have you had direct reports:

i. If you manage direct reports, how many direct reports do you have:

j. If you lead a department/function – how many total employees are within your
scope of responsibility including your direct reports (N/A if not applicable):

8. Please provide a paragraph describing your current job responsibilities (be specific).

9. Please provide a paragraph describing any past job responsibilities that would be relevant to the mentor selection process (be specific). For example, if you don’t currently manage direct reports, but did so in the past, please describe.

10. Is there anything else you would like to add that you have not been asked?

Please complete this application, and email it to mentoring@wictrm.org. Applications must be received by Sep 7 2007. Participation and mentoring team assignments will be communicated by Oct 4th, 2007. Initial training and the program kickoff is scheduled for Oct 12, 8am – 5pm (location Level3 Communications in Broomfield). Attendance is mandatory.

It is recommended that you obtain your employer’s/manager’s support for your participation in this program and that you fully understand any limitations your manager may have on your participation.

Program Cost

The cost of this program is will cost $375.00 – member; $450 – non-member (payable to WICT upon mentor assignment).

Please include payment information below. Only those who are accepted into the program (given space constraints) will be charged.

Amount Paid: ________________

WICT Member

Non-member

Charge To:

MasterCard

Visa

American Express

Direct Bill

Card Nnumber:		Exp. Date:
Card Holders Name:

Please feel free to contact any of the individuals listed below with questions or comments:

Contact Information

Please contact any of the following individuals for further information.

Leslie Russell WICT Mentoring Program Fall Session Co-Chair VP, Sales and Marketing Comcast Media Center Leslie_Russell@cable.comcast.com 303-486-3809 office 303-886-0415 cell	Carolyn O’Hearn WICT Mentoring Program Fall Session Co-Chair Director of Project Marketing Comcast carolyn_ohearn@cable.comcast.com 303-766-1384 office 720-273-1532 cell
Susan Baker WICT-RM Board Mentoring Program Co-Chair Introspect International susan.baker@introspectintl.com (303) 942-9610 office 303-946-4040 mobile	Marti Moore WICT-RM Board Mentoring Program Co-Chair Level3 Communications, Inc. Marti.moore@level3.com 720-888-2323 office 303-261-6065 mobile

Thank you for participating in the personal development program.
We are looking forward to working with you.

Mentee Participation Checklist

Review the mentor profiles.
Review the program overview with your supervisor.
Complete the attached application, including payment information.
Submit the completed application to: mentoring@wictrm.org
Applications must be returned by September 7th , 2007 . Assignments will be made on the basis of developmental interests and mentor/mentee preferences on a first come, first served basis. It is recommended that you get your material in as soon as possible.

Participants will be notified of their participation and informed of training program logistics.

WICT – Rocky Mountain Chapter P.O. Box 21261 Denver, CO 80221