<p> AFP Bluegrass Chapter Mentor Application Form</p><p>I volunteer to serve as an AFP Bluegrass Chapter Mentor, will promote AFP affiliation and subscribe to AFP’s Code of Ethical Principles and Standards of Professional Practice. </p><p>Personal Information: Name: Place of Employment & Position:</p><p>Phone and Email:</p><p>Address Preference for Mentorship Program: (place “x” below)</p><p>Home Work Other</p><p>Address above checked: </p><p>AFP Membership Information: (place “x” where applies)</p><p>Current AFP member Former/Retired AFP member </p><p>Other Professional Affiliations (List) </p><p>Professional Experience:</p><p>How long have you been involved in fundraising? Include professional and volunteer service. Professional: # of Years Volunteer: # of Years </p><p>How many fundraising staff/development staff does your organization support? </p><p>Please indicate areas of experience/expertise (use “x” for all that apply):</p><p>__Strategic Planning __Annual giving (direct mail/on-line) __Executive Management __Corporate/Foundation Fundraising __Special Events __Consulting/third-party fundraising __Career Development __Communications (Case Development) __Major Gifts-Individuals __Board Governance __Gift Administration/Data Management __Planned Gifts __Prospect/Donor Research __Social Media Fundraising __Grant/Proposal Writing __Stewardship/Gift Reporting __Donor Recognition __Volunteer Management __Public Relations/Marketing AFP Bluegrass Chapter Mentor Application Form __Merchandise Sales __Capital Campaigns __Sponsorships __Other (______) __Donor Development</p><p>2 AFP Bluegrass Chapter Mentor Application Form</p><p>Organizational Experience (use “x” for all that apply):</p><p>__ Health __ Education __ Grassroots Advocacy __ Environmental __ Arts __ Religious __ Social Services __ Animal Rights __ Children/Youth __ Human Rights __ Consulting __ Other (Describe)</p><p>Additional Matching Information:</p><p>What is your preferred method of communication for your mentoring relationship?</p><p>Face-to-Face Telephone Email Other Social network (First meeting should be face-to-face) (Avoid entire “email” relationship)</p><p>Which mentoring arrangement do you prefer? (use “x”) One to two meetings Multiple meetings I’m flexible; Per mentor w/ same mentor whatever’s needed</p><p>Would you be willing to have more than one mentee? (use “x”)</p><p>Yes No </p><p>Application Process & Expectations</p><p>Either scan/send or email completed forms to Mentoring Committee Chair, Mike Stratford ([email protected]). The Committee will match pairs based on your responses. Complete Program Guidelines will be emailed or picked up at the September chapter meeting. The relationship is meant to be career specific and is not a consulting relationship. Mentees are asked not to use the program for job seeking. The Mentor is responsible for facilitating all mentor sessions . While there is no hard-fast rule, sessions should last no more than an hour and no more than once or twice a month. Mentors are encouraged to recommend appropriate resources (i.e., courses, workshops, educational opportunities, publications, books, etc.)</p><p>We recommend that each Mentor advise his/her employer about participation in the program.. If unable to schedule a first meeting or have any other questions, please notify Mike. Each Mentor agrees to complete a brief survey at the conclusion of the mentorship period. An awards ceremony will conclude the program.</p><p>~ ~ ~ This mentorship cycle should conclude by May 31, 2017 ~ ~ ~</p><p>*The information collected on this form will be used only for the purposes of determining a mentorship match and not shared outside the AFP Bluegrass Chapter Mentoring Committee or Board.</p>