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OFFICE OF HUMAN RESOURCES

Mentor Form

I am interested in volunteering as an employee mentor

I am interested in having a mentor

Name:

Department:

Current Position Title:

Status:

Years in Profession:

Years at TU:

Contact Information:

Phone:

E-mail:

 

Education:

Degree:

if other please specify:

Major:

Minor:

Typical Work Schedule:

Do you have prior experience as a mentor? If so, explain.

Do you have prior involvement with a mentorship program as a mentee? If so, explain
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Activities involved with (on/off campus):

Reason for Request:

Desired Outcomes:

 

Contact Training & Development by email at hrtraining@towson.edu or on extension 4-6015 for additional information or assistance.

 

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