I am interested in volunteering as an employee mentor

I am interested in having a mentor

Name:

Department:

Current Position Title:

Status:
Non-Exempt Exempt

Years in Profession:

Years at TU:
Under 1 year 1-4 years 5-10 years 10+ years

Contact Information:

Phone:

E-mail:

Education:

Degree:
Associates Bachelors Masters Doctorate Other
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 Staff Training & Development by email at hrtraining@towson.edu or on extension 4-6012 or 4-6015 for additional information or assistance.