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Mentor Application

Please complete the entire form and click on the 'Submit' button to submit your entry. All fields with * are required.



BIOGRAPHICAL INFORMATION
*Suffix: Mr.    Ms.    Mrs.   Dr.
*Last Name: *First Name: Middle Initial:
Company Information:
*Title:
Department:
*Name:
Address: Suite #:
City: State: Zip Code:
Phone:        
Fax 1: Fax 2: Cell Phone:
*E-mail:   Assistant's Name:
Home Information:
Address: Suite/Apartment #:
City: State: Zip Code:
Phone:        
*Which phone numbers do you want to release to your students?
  All   Business   Fax    Cellular   Home    None
*Do you want your email address released to your students?
  Yes    No
*Are you a University of Miami Alumni?
  Yes    No
*Education:
  Institution(s) Degree(s) Year(s)
Citizenship:
Other than English, I speak the following languages:
 
*I participated in the Mentor Program last year.
  Yes    No
If yes, name of student:
 
If yes, would you like to remain with the same student?
  Yes    No
*I would be interested in participating in Roundtable Discussions with students and other mentors.
  Yes    No    Maybe
How did you first hear about the Mentor Program?
 
PROFESSIONAL EXPERIENCE
*Do you have international business experience?
  Yes    No
If so, in what countries/areas?
 
What percentage of time do you spend traveling to these areas?
   %
*In what industries do you have experience in? (Please choose your top 4):
  First Choice:
 Second Choice:  
  If Other:
 If Other:
  
  Third Choice: Fourth Choice:  
  If Other:
 If Other:
  
*In what functional areas of business do you have experience in? (Please choose your top 4)
  First Choice:
 Second Choice:
  
  If Other:
 If Other:
  
  Third Choice:
 Fourth Choice:
  
  If Other:
 If Other:
  
 
RÉSUMÉ
To facilitate the matching process, please upload your most recent résumé, which includes your
educatonal background, work, experience, memberships, and recognitions.
Select the file you wish to submit (.doc, .docx, .pdf):
   
What special experiences have you had that might be valuable to share with a student
(e.g., starting your own business, changing career paths, relocation,
family issues, corporate culture)?
 
MATCHING CRITERIA
Please describe yourself. This will help us make the most appropriate match.
*Gender: Male    Female
*Age: 20-29   30-39  40-49     50+
*Years in Business 1-5       6-10    11-15     16+
What are your preferences in a student? (If you do not have a preference, check "None")
*Gender: Male    Female    None
*Age Range: 19-20   21-22      23-24    25+    None
*Class Level: Junior    Senior    Graduate Student    None
*Number of Students you would like to mentor:
  1    2    3
Other preferences:
The contact information in your application will be made available only to the student with whom you are eventually matched. In addition, your company name, address, and telephone number will be published in the Mentor Directory – only available to mentors. You will receive your student match information via mail when the matching process is completed in late August.
*“I have read the above statement and agree to the release of the information in my application as stated. I also agree that, if matched, I will devote a portion of my time each month to communicate and/or meet with my student and keep the Mentor Program Office updated with my current contact information (address, email, and telephone).”
 
    School of Business Administration
    P.O. Box 248027, Coral Gables, Florida 33124-6520
 
 
TEL: 305-284-4643
FAX: 305-284-6526
 
GRADUATE: 305-284-2510
UNDERGRADUATE: 305-284-4641