Protégé Application Assessment Protégé Application Assessment In order for us to better fit you with the appropriate Mentor, please provide the following information: Name* First Last Email* PhoneHave you ever been in a Protégé/Mentor relationship/program?NoYes, but it was an informal relationshipYes, but it was in a formal program:What was the name of the program?If you have been in a Protégé/Mentor relationship/program in the past, what did you find valuable? What wasn’t valuable about the relationship/program?What are your career objectives?What is your area of expertise/field of employment? Please list all experience or job description.What do you plan to achieve as a result of this program? Please include professional, academic, personal, leadership, extracurricular, and any other goals you plan to accomplish via this program.Do you want to be matched with someone in your area of expertise?Yes, I would like to be matched with a Mentor from my field of security.No, I would like to be matched with someone from a different field of security.I do not care if the Mentor is in my field or in a different field of security.What do you see as the purpose of your mentored experience? Select your three most important mentoring needs at this time. On-going career development Networking Used to solve a long-term project Area specialty development and practice Skill improvement Guidance on job searches Company/Industry cultural comprehension Resume critiques Educational foundation expansion Mock interviews Broader quality performance Informational interviews Enhance/Increase professional visibility Project collaboration and/or critique Practice strategies Other: What mechanisms of communication do you have available to you to interact with your Protégé? Supply information on those you wish to use. Business Phone: Cell Phone: Business e-mail: Personal e-mail: Go-to-meeting capabilities: Live chat: Video conferencing: Face-to-face meetings: Other: Business PhoneCell PhoneBusiiness e-mailPersonal e-mailGo-to-meeting capabilitiesLive chat:Video conferencing:Face-to-face meetings:Other:What type of feedback do you expect from your Mentor?I would like to receive both verbal and written feedback from the Mentor.I would like to receive only verbal feedback from the Mentor.I would like to receive only written feedback from the Mentor.I would like my manager/supervisor to be aparty to both my verbal and written feedback from the Mentor.I would like my manager/supervisor to only receive written feedback from the Mentor.I would not like my manager/supervisor to receive any feedback from the Mentor. I wish towork with the Mentor exclusively.Do you want your manager to participate in the program with you?Yes, I would like feedback to my manager from my Mentor on my progress.No, I do not want my manager to participate in the program with me. I will share myprogress as I feel necessary.How long do you feel participation in this program will take to achieve your stated goal?6 months or less—i.e., specific project1 year or less—i.e., general planLonger than 1 year—continuing enhancementCAPTCHAEmailThis field is for validation purposes and should be left unchanged.