Application Form – MENTOR – Minority Executive Leadership (MEL) Certificate Program MEL Mentor Application – Mentoring Period – January – May First and last name* First Last Phone numberEmail address Who is your employer (if applicable)?What is your role with the above organization?How did you hear about the Certificate of Minority Executive Leadership Mentoring Opportunity? * C4NPR’s website C4NPR’s E-newsletter Word of mouth Flyer Alumni Invitation by The Center for Nonprofit Resources Past Mentor Why are you interested in being a mentor for the Certificate of Minority Executive Leadership? *To ensure you are paired with an appropriate mentee/protégé, please answer the following question:In which area(s) have you developed a strong skill set and expertise? * Marketing and Communications Finance Human Resources Fundraising Management Leadership Organizational Development Programs What is your gender? * Male Female Are you Latino(a) / Hispanic? Yes or No*What is your race?* White/Caucasian African American/Black Asian Native American Native Hawaiian More than one race Please check all appropriate boxes.Minority groups are typically based on ethnicity, race, sexual orientation, religion or disability. Please specify the minority group you consider yourself a member of.Please write any additional comments or question(s) you may have.I have read and understand the expectations and requirements of a mentor for the Minority Executive Leadership certificate program. Yes No We will accept applications June 15 – July 15, 2022 If you need to contact us before this time please email Milva at [email protected] or call (419) 241-9513.CAPTCHAWebsite Email
