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Mentor Application
SINE Mentor Application
Step
1
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5
20%
What is your legal first name?
First
What is your preferred name?
*
What is your legal last name?
*
Last
Please provide the best email address at which to contact you:
*
Please provide a secondary email at which we can reach you:
What is the best way to contact you?
*
Email
Text
Phone call
What is your preferred phone number?
*
Along with email and phone, the program uses text messages to communicate. Checking "Yes" indicates your permission to contact you by cell phone text message. Message and data rates may apply. May we text this number?
*
Yes
No
Please select the option that best reflects your gender:
*
Male
Female
Non-binary
Prefer to self-describe
Prefer not to say
Please describe your gender.
*
Please check the option(s) that best identify your Race/Ethnicity. Check all that apply.
*
Black/African American
Latina/o/e/x
Asian
Pacific Islander/Native Hawaiian
Native American/Alaskan Native
Middle Eastern/Northern African
White
Prefer not to say
Other
If you selected 'Other' above, how would you describe your Race/Ethnicity?
Please share your countries of descent.
Do you identify as Black, Indigenous, and/or a Person of Color?
*
This question helps us to review this feedback with an equity lens by being intentional in acknowledging the experiences and perspectives of BIPOC communities.
Yes
No
Not sure
What is your Date of Birth?
*
MM slash DD slash YYYY
Please select the option(s) that best describes your relationship to Oregon/SW Washington:
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From/grew up in/have family in the area
My permanent address is in Oregon/SW Washington
I currently live in Oregon/SW Washington
I attend(ed) college in Oregon/SW Washington
I don't currently have a connection to Oregon/SW Washington
Other
Please describe your relationship to Oregon/SW Washington
Please select the option that best describes the type of community you grew up in:
*
Rural
Urban
Suburban
Residence Information
Please provide the address at which you currently live and we can send you mail
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
In what county do you currently reside?
*
Baker
Benton
Clackamas
Clark
Clatsop
Columbia
Coos
Crook
Curry
Deschutes
Douglas
Gilliam
Grant
Harney
Hood River
Josephine
Klamath
Lake
Lane
Lincoln
Linn
Malheur
Marion
Morrow
Multnomah
Polk
Sherman
Tillamook
Umatilla
Union
Wallowa
Wasco
Washington
Wheeler
Yamhill
Outside Oregon / SW Washington
What is your current ZIP code?
*
ZIP Code
If different, what is your permanent ZIP code?
ZIP Code
Have you lived in (what you consider) rural Oregon in the last 10 years? If so, please name the town(s) and length of time
*
Education Information
What is your highest level of education?
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Less than a high school diploma
High school diploma/equivalent
Associates Degree
Bachelor's Degree
Master's Degree
Doctoral Degree
From what college did you receive your most recent degree?
*
Please share your college graduation date (MM/YYYY):
*
Most recent degree. Day is not required.
Month
Day
Year
Please share your specific degree earned:
*
For the above graduation/degree (e.g. BA, BS, BSW, BSS)
Please indicate your major or field of study:
*
For the above graduation/degree (e.g. Engineering, Journalism)
Please share your minor and/or additional certificates obtained (if applicable):
For the above graduation
Please select the option that best reflects your parents’ college attainment:
*
Neither of my parents attended college
One or both of my parents attended some college but did not complete a bachelors degree
One or both of my parents completed a bachelors degree
Career Information
Ability to work in the U.S.
*
U.S. Citizen
U.S. Permanent Resident (Green Card)
Another type of eligible work status
I am not eligible to work in the U.S.
Are you currently working?
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Yes
No
Please select the option that best reflects your current employment status:
*
Full-time employee
Part-time/temporary employee
Independent contractor
Unemployed
Seeking employment
Not currently seeking employment
Other
Please briefly describe your employment status.
What is the name of your current employer?
*
What is your current job title?
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Please briefly describe your work/training history.
*
This can include educational experience.
Please share your LinkedIn URL (optional):
Please select the option that best reflects the primary job grouping you have work experience within.
*
This could be job role or industry. Select 2 options maximum.
Business & Entrepreneurship
Finance & Accounting
Marketing & Communications
Operations & Projects
People & Engagement
Technology
Other
Please briefly describe your other primary work experience.
*
Please select the option that best reflects the secondary job grouping you have work experience within.
This could be job role or industry. Select 2 options maximum.
Business & Entrepreneurship
Finance & Accounting
Marketing & Communications
Operations & Projects
People & Engagement
Technology
Other
Please briefly describe your other secondary work experience.
How many years of work experience do you have?
*
SINE mentors should have at least 2 years of professional work experience.
0-1
2-3
4-5
5+
Social Mobility Competencies
SINE seeks to support leaders of color in professional and financial development. The mentoring experience will have four focus areas: financial education, wealth building, leadership development & career advancement, and civic & community engagement.
Please rate your understanding/knowledge in the following areas:
Financial Education
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Understanding and ability to use financial knowledge to help set/adjust goals to develop healthier financial habits over time (e.g. budgeting, saving, credit tracking)
Just Learning
Somewhat Developed
Very Developed
Wealth Building
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The practice of establishing new financial security and wealth-building opportunities (e.g., retirement fund, investment in stocks, savings account, managing debt).
Just Learning
Somewhat Developed
Very Developed
Professional/Leadership Development
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Building capacity for effective leadership and developing skills for career advancement
Just Learning
Somewhat Developed
Very Developed
Civic and Community Engagement
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Policy, advocacy, volunteer work, uplifting BIPOC and marginalized communities
Just Learning
Somewhat Developed
Very Developed
Mentoring Insights
What are areas you feel like you could support mentees in?
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Resume/cover letter development
Career planning
LinkedIn creation/updates
Mock interviews
Professional networking
Grad school preparation guidance
401K investment
Homebuying insight
Other
Please briefly describe what other area(s) you could support mentees in.
*
Please select the top 5 qualities you possess as a mentor:
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Ability to network and find resources
Active listening skills
Availability to devote time
Compassion and genuineness
Confidence and ability to motivate
Honesty and integrity
Industry knowledge
Passion for continual learning
Positive outlook
Resilience and adaptability
Have you ever been a mentor?
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Yes
No
How did that impact you?
*
Please briefly describe your motivation for applying to be a mentor.
*
What types of mentoring do you feel comfortable with?
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Individual - Meet one-on-one with a mentee
Group - 3 mentors with 5-9 mentees in a group
Both
Are you available to meet with mentees at least once a month for 1-2 hours over a 12-month period?
*
Yes
No
What are the best days/times you are available to meet with mentees? (Select all that apply)
*
Weekday Mornings (7am-12pm)
Weekday Afternoons (12pm-5pm)
Weekday Evenings (5pm-9pm)
Weekend Mornings (7am-12pm)
Weekend Afternoons (12pm-5pm)
Weekend Evenings (5pm-9pm)
Other
If you selected "Other" above, please indicate other days/times you are available to meet.
Based on the previous question, what are the best days of the week for you to meet with mentees? (Select all that apply)
*
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
Mentors are required to have a background check. Do we have your permission to run a background check?
*
Yes
No
Have you ever participated in diversity, equity or cultural competency training?
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Yes
No
Please explain your answer
How did you first learn about SINE?
*
Do you personally own or have regular access to the following technology?
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Smartphone
Tablet
Laptop computer
Desktop computer
Wireless Internet
Please check any of the following programs of The Contingent programs you have participated in (if applicable):
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Emerging Leaders Mentoring
Emerging Leaders Internship
Act Six
Ready to Rise
Ignite Scholars
None of the above
SINE Survival Is Not Enough Mentor Agreements
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WHAT DOES SINE COMMIT TO PROVIDE?
- Professional Learning Community
- Access to a Strong Job Network
- Deep Connections through Mentorship
As a mentor of the SINE cohort, you make a commitment to the growth and development of members and the SINE community. Please confirm that if accepted to the program, you can agree to the following:
- Mentors agree to attend mentor training to prepare for the mentoring experience.
- Mentors agree to meet with mentees at least once a month for 1-2 hours over a 12 month period.
- Mentors agree to submit monthly mentoring notes and complete Circle surveys.
- Mentors agree to attend a minimum of 2 meetups/“SINE IN” intentional networking events.
- Mentors agree to walk alongside members as they grow in the areas of financial education, leadership development, wealth building and civic & community engagement.
The Contingent never shares your information for commercial purposes. We use data for reporting on the effectiveness of our programs and to address the requirements of grant funders. By participating in SINE, you agree to have your information used for these purposes.
I agree to the SINE Mentor Agreements.
Please sign your full legal name below by typing in the text box.
*
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