BioCenter Mentor Application

							Mentor Application Form
         SJBC Mentors provide invaluable pro bono assistance in their areas of expertise
                           ”Make the Difference – Nurture Success”

Instructions
       Send completed form and Curriculum Vitae to Melinda Richter at the address/fax below.
       A facility tour/interview appointment will be arranged to share SJBC vision and mutual goals.
       Notification of your mentorship status will be sent by email within 2-3 weeks of interview. You will
        be asked to sign a mutual nondisclosure agreement for yourself/your company.
       Topics and Schedule of mentor sessions with clients will be arranged per mutual availability.
       Questions? Contact Melinda Richter for more information.

Name:                                                     Email:
Title:                                                    Bus Tel:
Company:                                                  Cell:
Business Address:
Hours available/month to mentor:


In which functional areas do you have expertise (check all that apply)?

  Team and Management
         Management Team                          HR Processes
         Organization Development                 Board of Advisors
         Board of Directors

  Marketing and Sales
         Target Market                            Market & Revenue Projections
         Business Model                           Pricing & Reimbursement
         Marketing Plan                           Competitive Positioning
         Channel Strategy                         Direct Sales

  Products and Services
         Products & Services Definition          Product Management
         Product Development                     Manufacturing Planning
         Customer Service                 Customer Satisfaction

  Finance and Capital
         Capitalization                                    Financial Statements
         Accounting & Financial Management        Fundraising Materials & Investor Com

  Legal and Regulatory
         Corporate Legal Structure                Intellectual Property
         Regulatory                               Taxation

Do you have significant CEO experience?

What is your primary reason for wanting to be a SJBC mentor?




Please paste your bio here as you would like it to appear (no limit on length):

Please also attach your resume.

Thank you for becoming a San Jose BioCenter Advisor!



                                           Send or Mail to Melinda Richter, CEO
                             San Jose BioCenter • 5941 Optical Court • San Jose, CA 95138
                   Phone# 408.960.3807 • Fax# 408.960.3822 • Email: melinda@sjbiocenter.com