Mentor Match Program:

MENTEE Application

Please complete this application to help us get to know you and your business, as well as how to contact you. Please note that you must be an established business of at least 3 years to qualify for participation in the Mentor Match program.

 

Please complete the form below

Name *
Name
Phone *
Phone
Race
$
Date Established *
Date Established
Business Address *
Business Address
http://
2017
2016
2015
(Please attach these plans with your application, if applicable.)
(Please attach these plans with your application, if applicable.)
I understand that by signing below, I am agreeing to the terms of the Mentor Match program facilitated by the Women’s Small Business Accelerator, Inc. I also understand that the WSBA does not perform any tasks on behalf of or for program attendees. As a program attendee I take full responsibility and liability for the implementation of any feedback. Completion and submission of the application is merely a request for entrance into the Mentor Match program, and not a guarantee of acceptance, as participation in the program is based on availability of a Mentor to match a Mentee (applicant’s) needs. Information provided in this form helps the WSBA understand the audience we address and will be kept strictly confidential within WSBA and its partner organizations and evaluators. Additional terms: • The application fee is $100 and is non-refundable. • If a match does not occur, the application fee can be applied toward a future WSBA program. • The program participation fee is $500 for the six-month program, which will be charged automatically once we secure a match for you. • All participants, including Mentors and Mentees, and all volunteers will be required to sign a non- disclosure/confidentiality agreement. • All participants, including Mentors and Mentees, and volunteers will be required to give us permission to use their name, company name and a professional photo in a WSBA media release, marketing, and the WSBA website for the purpose of promoting WSBA and its programs. However, no proprietary information will be used. By signing this application, you are giving the WSBA permission to use the information described above. • Mentees are required to complete an orientation program before being matched with a Mentor. This program will cover the expectations of being a Mentee, how to work with Mentors, and working with the WSBA. Further, I attest that my business is owned at least 51% by me, a woman business owner.
Mentor Match Program Fees
from 100.00

By completing this form it confirms your permission for the Women’s Small Business Accelerator to charge your credit card a $100 deposit and a $500 program non-refundable fee at the start of your participation in the Mentor Match Program. If you have any questions, please call us at 614-414-2449 or email us at admin@wsbaohio.org.

Mentor Match Payments:
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