C4 Mentorship Program

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Contact Information

Date:

Name:

Current Title:

Company:

Email:

LinkedIn:

Twitter:

Other Relevant Social:

Work Address:

City:

Province:

Phone:

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Preferred language:

English

French

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Length of time with current employer:

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Years of channel work experience (please check the appropriate box):

1-5 years of experience

6-10 years of experience

10+ years of experience

Goals & Objectives

It is important that we understand your goals and preferences to make the best possible mentor match. Please note that while C4 strives to make the best possible match, it may not be possible match all applications.

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Have you had a mentor(s) in the past?

Yes

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Was it

Formal?

Informal?

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If you have been involved in another mentorship program, please tell us about the organization and program:

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What would you regard as positive outcomes of a successful mentorship relationship? What does success look like to you?

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Of the following professional priorities/areas of focus, please indicate the top three on which you would focus a mentorship opportunity. (Please add to the following list if you have a priority not listed)

I want to develop and advance my career

Enhance my channel leadership potential

Expand my influence

Hone my management and people-management skills

Stay relevant with changing industry realities/dynamics

Other (please specify)

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In addition to the above goals for mentorship, which of the following channel competencies would you most like to develop (please select up to three):

Strategy development

Financial acumen

Change management

Channel Building

Marketing

Operations

Talent Management

Leadership

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What positive attributes and/or experiences/skills would you bring to a mentorship relationship and be able to share with your mentor? (Unique/interesting experience; perspective; attitude; competence/ability)

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Is there anything else that we might have missed or should be aware of to create a workable partnership for you?

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Expectations of Program Participants

I have read and understand the expectations of participating in the C4 Mentorship Program.