Mentor Application Form

Thank you for your interest in participating as a mentor in the BAPA Mentorship Program! Please complete the following application to help us better understand your background, expertise, and mentoring interests so we can create the best possible mentor-mentee match.

Mentor Application

Name

First

Last

Email address*

Phone Number*

Which cohort(s) are you applying to? (Select all that apply)*

Fall/Winter Cohort: (September – February)

Winter/Spring Cohort: (January – June)

Please provide a brief professional bio, including your current role, field of expertise, professional experience, and areas where you can offer mentorship.*

How many years of professional experience do you have in your field? *

Please list any degrees, certifications, or relevant training you have received.*

Have you ever mentored anyone before? If yes, please describe your previous experience.*

Why are you interested in participating as a mentor in this program? *

What impact do you hope to have as a mentor, and what outcomes would you like to help your mentee(s) achieve?*

Professional Headshot*

Please upload a clear, high-quality headshot.

LinkedIn Profile (URL)

Is there anything else you would like to share?

Communications & Recognition Consent*

I acknowledge and consent to BAPA using my name, professional bio, headshot, and mentorship participation in program communications (e.g., social media, website, newsletters, and other promotional materials). I understand that my personal contact information and mentor matching information will remain confidential.

Mentorship Commitment*

I commit to dedicating at least 6 hours throughout the mentorship cohort and actively participating in mentor meetings and program activities.