Office of Student Diversity & Inclusion

Professional Coach Interest Form

If you are interested in becoming a professional coach for the Office of Student Diversity Programs (OSDP) Mentorship Program, fill out the form below. Students, if you are interested in signing up, go here.

First Name:*

Last Name:*

Pronouns (optional):(Description: The pronoun or set of pronouns that one uses to refer to an individual in the third person. A person can have multiple, interchanging sets of pronouns, and may use different sets in different circumstances. Example: she/her/hers, they/them/theirs, etc.)

Occupation/Title/Department:*

Business Address:*

Business Phone:*

Email:*

Home Phone (optional):

Cell Phone (optional):

Race (optional):

Ethnicity (optional):

Gender Identity (optional):

Gender Expression(optional):

Sexual Orientation(optional):

Please provide any information about your background and/or interests which would be of use in developing a mentoring relationship:

Please tell us when is the best time to communicate (Skype, Zoom, phone, email, etc.) with your Mentee. (days/hours, evenings/weekends)

Monday

Tuesday

Wedensday

Thursday

Friday

Saturday

Sunday

Please select one from the following choices:

I am an existing Professional Coach/ I have served as a Professional Coach/Mentor in the past

I am a first time Professional Coach

Please choose one from the following:

I am only able to mentor one student.

I am willing to mentor more than one student.

If you are willing to mentor more than one student. How many students would you like to mentor?(PLEASE NOTE: We do not assign more than three mentees per individual. The number of mentees you are assigned will be based on the number of students who are participating in the program.)

Optional: Please enter any preferences that you have for your Mentee(s). Major, Race, Ethnicity, Gender Identity, Gender Expression, etc.(Keep in mind that this information will only be considered based on availability)

SKIDMORE COLLEGE

Office of Student Diversity Programs (OSDP)

MENTORSHIP PROGRAM AGREEMENT FORM

The goal of the Mentorship Program is to pair first year students who identify as LGBTQ+ or as students of color with an OSDP Student Mentor who also identifies in this way. Through this program, first year students develop a support system on campus, an opportunity to network, and are exposed early to the resources the campus has to offer.

Additionally, we aim to pair all OSDP Student Mentors with a Professional Mentor/Coach. As a Professional Coach you will advise, support, and encourage and OSDP Student Mentor. You will also assist them with achieving their own personal, academic, and career goals.

In order to ensure the mentoring relationship will be effective, we ask that you commit to work with a student for one full academic year. It is also advised that you communicate with the student electronically or via phone at least twice a month. Lastly, we will provide you with an evaluation form at the end of each semester.

PROFESSIONAL COACH COMMITMENT

I agree to:

Commit to mentoring my mentee for one academic year (2 semesters);
Communicate with assigned mentee(s) (Skype, Zoom, phone, email, etc.)at least twice a month for one year;
Initiate contact with my mentee(s) at least twice a month;
Create academic, social, cultural, or career goals with my mentee(s);
Share my educational, career and professional journey;
Serve as a positive role model;
I will respect boundaries and confidentiality in the mentoring relationship;
Help my mentee(s) complete their mentor interview assignment;
*Participate in mentor related activities such as OSDP Mentor Program mixers (*This applies to mentors who are present on the Skidmore campus);
Respect and honor the identities of my mentee(s); and
Respect my mentee(s) own process and pace toward achieving their educational and career goals.

I have read the above agreement, and I understand what is expected of me as a Professional Coach. *Name

Date:*

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Professional Coach Interest Form

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