2024 CLS Mentorship Application Form

The Purpose of Community Leadership School Mentorship Program is to help connect knowledge seekers (CLS Students) with knowledge bearers (Professional Mentors). These relationships provide mentees the opportunity to connect in meaningful ways with someone whose past experience can help them navigate careers and life.

Completed Applications must be received by November 29, 2023. All applicants will be informed of their status by December 8, 2023. The Welcome Mixer for new students and mentors will be held on January 17, 2024.

For further questions, please contact Kourtney Ramsey at info@peoriachamber.org or 309.495.5914.

Name *

E-mail *

Business Phone *

Business/Organization Name *

Job Title *

CLS Graduation Year if Applicable

Please indicate areas you would be Happy to provide Mentorship In

Career Planning and Development Managing Teams/People Conflict Resolution Networking/Consulting Skills Understanding Organizational Structure Project Management Media/Community Engagement Strategic Planning

Describe briefly the areas in which you feel you can be most helpful in providing mentorship. *

Are there any aspects of your work situation that we need to take into account in assigning you a mentee? (busy timetable, confidential work or going away for vacation etc) *

Is there any personality traits in a mentee that would make a match uncomfortable for you? *

Other Consideration: Is there anything else you would like to add to your application information to assist us in the pairing process? *

Mentor Full Name *

Type your full name in the box above to confirm that you have reviewed and understand the mission, mentorship program requirements, selection process, and mentorship participation commitment to the Peoria Area Chamber of Commerce Community Leadership School. If selected, I will devote time and support to my paired mentee. If I am unable to comply with the requirements, I will voluntarily withdraw from the Mentorship Program.

Date of Application Submission *

Format: M/d/yyyy

Select Date of Application Completion

2024 CLS Mentorship Application Form

Peoria Area Chamber of Commerce

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