First & Last Name
Preferred Email
Job Title
Organization
Address:
City:
State:
Zip:
Work Phone
Cell Phone
Years of Experience in Fundraising
Current Budget Size
Please check how you identify MaleFemaleNon-binaryOther
Please check your ethnicity Middle Eastern/North AfricanAmerican Indian or Alaska NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Other Pacific IslanderWhite
Agency Type Arts/CulturalHealth/Human ServicesHigher EducationOther
Number of Employees in Development/Advancement Department 1-34-78-1010+
How many times are you willing to meet with your mentee/mentor: 3-56-910+As much as possible
What are your areas of focus you want to mainly discuss with your mentee/mentor: Fundraising areas of practiceNetworkingCareer AdvancementCFRE Information/Study PartnerWorkplace Problem Solving
If you checked fundraising areas of practice, which areas would you like to focus on: Annual GivingBoard DevelopmentCapital CampaignsCommunications/Public RelationsCorporate/Foundation RelationsDirect MailDonor Recognition/StewardshipGrants/Proposal WritingMajor Gifts/Moves ManagementMarketingPlanned GivingSpecial EventsSponsorshipStrategic PlanningVolunteer ManagementOther (please list)
If other: please list
Please indicate 3 measurable goals you would like to accomplish with the assistance of a Mentor
Do you agree to the Memorandum of Commitment? YesNo