Mentoring Profile for Minority Executive Leadership (MEL) Certificate Program

Mentoring Profile for Minority Executive Leadership (MEL) – Certificate Program – Participant Form

Please submit by September 30. Applications submitted without a Mentoring Profile will be considered incomplete. Responses on this form will be used to match participants with appropriate mentors. Please note that these answers will be shared with your assigned mentor to provide the best experience possible. Please provide specific answers to the questions.

First and last name*
First Last
Preferred Email*
What would you like from a mentor? Please be realistic and limit your answer to two (2) priorities. You can expect support and advice from a mentor, but he or she cannot solve your problems.*
What outcome(s) would you like from a mentoring relationship? Please be realistic and limit your answer to 2-3 specific outcomes.*
What are the three (3) top skills or practice areas you would like to focus on. Please select a maximum of three (3). Thank you!
- Marketing and Communications
- Finance
- Human Resources
- Fundraising
- Management
- Leadership
- Organizational Development
- Programs
- Other
Other: Please specify
Finally, set three (3) goals for your mentoring experience. What would you like to achieve? Make sure you have SMART goals (Specific, Measurable, Attainable, Realistic, Timely).*
Before you submit this form, please print a copy for your records to be used as a reference throughout your mentoring experience. (Print as a pdf to your computer files or hard copy to your printer.)
If you have any questions, please call Milva Valenzuela Wagner at 419-241-9513. To access the Minority Executive Leadership Requirement Timeline, please visit: https://c4npr.org/wp-content/uploads/2024/07/Program-Checklist-MEL-2025.pdf
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Mentoring Profile for Minority Executive Leadership (MEL) – Certificate Program – Participant Form

Before you submit this form, please print a copy for your records to be used as a reference throughout your mentoring experience. (Print as a pdf to your computer files or hard copy to your printer.)