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Chatham University Center for Women Entrepreneurship
Mentoring for Women Business Owners Program 2008-2009
Mentee Application Form
Thank you for your interest in participating in the twelve month Mentoring for Women Business Owners program at the Center for Women’s Entrepreneurship at Chatham University. This program is being made available through the support of the Claude Worthington Benedum Foundation.

Your active and engaged participation is the key to our success. Please complete the information below as completely and accurately as possible. This will allow for the best possible match based on your strengths and interests. Mentors and Mentees will have monthly meetings, in addition to two program events yearly.
INFORMATION
Your Name :
Title :
Name of Business :
Type of Business :
Address :
City :
State :
Zip Code :
Business Phone :
Fax Number :
Email Address :
Years in Business : years
Number of Employees : Full-Time     Part-Time     Contractors
How did you hear about the mentoring program?
Why are you interested in having a mentor?
Please describe any previous mentors. In what ways have they helped you?
What specifically are you looking for in this program?
How do you plan to make time for the Mentoring Program in your already busy life?
As an emerging business owner, in what areas do you need the most help to move the business forward?
Please rate each of the following categories.

This information will be considered in finding the best possible match for your needs.

1 = “This is an area I need the most help in”
2 = “This is an area I’m comfortable with that is not necessarily a strength or a need”
3 = “I am completely comfortable and competent in this area and don’t need any help”
Marketing and Advertising
Accounting and Financial Management
Personnel and Hiring
Developing/Modifying a Business Plan
Managing Inventory
Business Structure and Organization
Operations and Production
Management and Leadership
Business Expansion
Strategic Planning
Time Management and Goal Setting
Pricing
Outsourcing
International Expansion
Family Balance
Other Areas Requiring Help    Please specify :
Please provide two business references
Contact Name :
Title :
Address :
City :
State :
Zip Code :
Phone :
Years Known : years
Business Context :
Contact Name :
Title :
Address :
City :
State :
Zip Code :
Phone :
Years Known : years
Business Context :
Comments?
Preferred Phone Number to Best Reach You :
Preferred Email Address to Best Reach You :
Please attach a current resume a link to your company websites. We truly appreciate your interest in our program and we will be contacting you soon.
I understand the cost of this program is $695 and agree to pay this program fee should I be selected as a mentee.
A limited number of partial scholarships are available. If interested, please check.
Center for Women’s Entrepreneurship at Chatham University
Braun Hall • Woodland Road • Pittsburgh, PA 15232-9910
(412) 365-1253 (phone) • womens-entrepreneurship@chatham.edu