MMASC Mentorship Program – Mentor Application

Phone

This field is for validation purposes and should be left unchanged.

Name

First Last

Title

Agency

Department

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

What areas of expertise can you offer as a mentor? (Check all that apply)

Field (Check all that apply)

Policy & Executive (City Council/Board of Supervisors, City Manager/County Executive Office, City Attorney/County Counsel)

Law & Justice (Courts, District Attorney, Public Defender)

Public Safety (Fire, Probation, Sheriff/Police)

Health & Public Assistance (ADMHS, Child Support, Public Health, Social Services)

Community Resources & Public Facilities (Agriculture, Housing, Community Development, Parks, Planning & Development, Public Works)

Support Services (Finance, Clerk, Facilities, Human Resources, Treasurer/Tax Collector)

Which region(s) would you prefer your mentee to come from? (Check all that applies)

Central Coast

Channel Islands

Desert

Inland Empire

North Los Angeles

South Los Angeles

Orange

San Diego

No Preference

Is there a specific mentee you would like to be paired with?

How many mentees are you willing to have?

What are you hoping to contribute to this program?

Is there any other information you would like to provide?

Please upload a short bio or resume

Max. file size: 50 MB.

In order to participate as a mentor, you must be an MMASC member (not a business member or sponsor).

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MMASC Mentorship Program - Mentor Application