MENTEE INTAKE FORM

Find Your Perfect Momtor Match!

Ready to get started? Complete our Mentee Intake Form (all fields are required) so that we can learn about your goals and connect you with the ideal Momtor. Please keep in mind that it may take up to 72 hours for us to review your information. After that, a member of our team will contact you to discuss the next steps in the program process. Please note that not all applications will be considered, and additional screening will be required before candidates can qualify to become a Mentee. The entire process may take a few weeks, so we appreciate your patience and understanding.

Mentee Intake Form

First Name:

Last Name:

Email:

Phone #:

Are you a parent?

Do you have any support at home in raising your child or children, or are you the sole caregiver?

Why do you want to become a Mentee?

What are you looking to accomplish with our Mentee Program? Check all that apply.

Business Growth

Business Investments

Career Advancement

Job Placement

Professional Resources

Which industry captures your interest the most?

Do you have prior experience in your preferred industry?

What is the biggest struggle you face trying to raise children & balance a career, and how can we help you overcome this obstacle?

What was the most significant challenge you faced in your career before becoming a parent?

What are your professional aspirations for the next 5 years?

What are your desired goals in being paired with a Momtor?

What is your primary professional objective in joining our Mentee Program?

If you achieve success in our program, would you consider taking on the role of a Momtor?

What is your date of birth? Due to legal requirements, we cannot provide help to anyone under the age of 18 without parental consent.

Please be aware that if your application is accepted, a background check will be conducted, and there will be a fee of $35.00 - $50.00 for the screening process. Please note that Momtor does not offer reimbursements or refunds regardless of the outcome of your application. It is important to understand that individuals with a history of violent offenses will not be considered for participation as either Mentees or Momtors. While we acknowledge that there may be discrepancies in your past, it is imperative to highlight that any violent offenses will not be taken into consideration.

Please upload your current resume.

Upload File

Your support can make a difference

Consider contributing as little or as much as you can. Every dollar donated goes toward keeping our programs and efforts moving forward.

Make a Donation

info@momtorinc.com

Costa Mesa, CA 92627

MENTEE INTAKE FORM

Find Your Perfect Momtor Match!

Mentee Intake Form

Your support can make a difference

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