Protégé Information Form If you would like to participate in Regis University's Mentoring Project, please complete and submit the following form by Friday, May 20, 2016. Questions? Visit The Mentoring Project web page or contact Steve Jacobs, Assistant Provost, at 303.458.3560. Your Name Last Name * First Name * M.I. Your Current Position at Regis University Title * Department * Regis Phone Extension * Regis Email Address * Regis Mail Code * Years in the Workforce Years Working at Regis Years in Current Dept. Current Position Description Past Jobs from Last to First Your Expectations and Interests Have you ever mentored someone or been mentored before? Describe your experience. What benefits or results are you expecting from this program? Check the areas of growth you are interested in. You may check more than one. Set career goals/timelines Develop leadership skills Learn about organizational structure, priorities, politics and culture Learn more about Regis University, its mission and your role Foster effective professional relationships Receive help with professional writing Find community outreach and education opportunities Assess your current skills and gain new ones Balance personal and professional priorities Receive individual recognition, support and encouragement Learn about the culture of a particular college, school, unit or department Understand university resources (e.g. budget, staffing, etc.) Have someone to connect with, someone with whom I can discuss issues about work, life and goals Any other areas of interest? What qualities are you seeking in a mentor? If you know someone who exemplifies these qualities, please list their name. Any information you would like a potential mentor to know about you? Describe your educational background, including any areas of special interest. Any educational plans or goals?