Advancement of Women

							                                Advancement of Women
                                   Mentee Application
                                    January-June 2009
                Please additionally submit a resume and a business card

Name: ______________________________________________________________

Current Position: _____________________________________________________

Department: ____________________________________________________

Email Address: _______________________________________________________

Office Phone Number: _______________ Office Fax Number: _______________

Address: ____________________________________________________________

Number of Years at GSU: ________ Number of Years in Current Position: ________

What are your short (1-2 years) and long (3-5 years) term career goals?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Select the top five (5) areas in which you would like to receive mentoring (Rank in order
of preference: 1 being the most preferred and 5 being the least preferred):

___    Administrative Experience – Academic Environment
___    Administrative Experience – General
___    Communication
       ___Writing Skills
       ___Verbal Skills
       ___Presentation Skills
___    Compliance and Ethics
___    Computers and Information Technology
___    Contracts and Grants
___    Creativity
___   Development of Staff
___   Finance and Accounting
      ___Financial and Budget Management
      ___Online Financial Systems
___   Food Services
___   Management Skills
___   Marketing
___   Negotiating
___   Office Administration
___   Personnel Administration
___   Project Management
___   Risk Management
___   Strategic Planning

Please list other skills, experience and knowledge areas in which you would like to
receive mentoring.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Why do you want to participate in the program?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

What do you hope to learn, understand or be able to do better as a result of your
experience as a mentee?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________


Please describe the characteristics of your ideal mentor.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
I am willing to sign a confidentiality agreement.

____ Yes                       No

I prefer having a female mentor.

____ Yes             ______ No Preference



Signature                                                 Date



           Please return your completed application to Dominique Holloman
                                 Fax: (404) 413-4001
                                Email: dominiqueholloman@gsu.edu
                            Campus Mail: P.O. Box 3975
       In Person: Department of Intercollegiate Athletics, Sports Arena, Suite 201

   Applications are due by 5:15pm, Friday, October 31, 2008