Professional Mentorship Nominator Form

This form is to be filled out by a nominator and submitted separately in support of the mentee’s application form.

Demographics
Nominator Name*
First Last
Organization (if applicable)
Pronouns:*
Email*
Email Confirm Email
Mentee Information*
List the mentee applicant you are supporting.
First Last
Mentee's Email*
Tell us about the mentee you are nominating
Relationship to the mentee*
How do you know this mentee? Give examples of how you are familiar with them and their creative work, including how long you’ve known them. (Max 150 words)
Relationship to the mentor
Are you familiar with the mentee’s proposed mentor? If yes, please list why you think they are a good match for this mentorship.(Max 150 words)
Mentee outcomes*
What do you think the mentee will gain from participating in this program at this stage of their career path? (Max 150 words)
Mentee accountability*
This program requires commitment over the 7 month period, including one on one time with their mentor, independent work, professional development and connecting, as well as keeping up communication with their mentor and responding promptly to monthly reports. Do you feel the mentee has the time, discipline, and determination to successfully complete this program at this point in time? (Max 150 words)
Additional Comments
If there is anything you feel was not covered in this application that would be helpful for us to know, please include here. (Max 100 words)

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Demographics