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Contact ID

Initiative ID

First name:

Last name:

Workplace name:

Job title:

Email address:

Is this the best contact email for you?

YesNo

Please provide the best contact email for you.

Phone number:

Is this the best contact phone number for you?

YesNo

Please provide the best contact phone number for you.

Gender:

Preferred gender of mentee:

Which type of mentorship format do you prefer most?

If it is not possible to hold the mentorship sessions in person, would you be open to participating in online sessions?

YesNo

The mentorship program involves 8 sessions lasting between 30 and 45 minutes over a four-month period. Are you able to commit to actively participating in the full program?

YesNoI am not sure

Please explain:

Please indicate your age group:

Country of residence:

Please specify the country:

What is your highest level of education?

Please specify your highest level of education:

How many years of work experience do you have?

In which of the following languages are you fluent? Please select all that apply, including your native language.

ArabicFrenchEnglish

How did you hear about the EFE Mentorship Program?

How else did you hear about the EFE Mentorship Program?

What do you hope to gain from being a mentor? Please select up to two responses.

First:

Second:

What else do you hope to gain from being a mentor?

What do you hope to contribute as a mentor? Please select up to two responses.

First:

Second:

What else do you hope to contribute as a mentor?

EFE Mentorship Program Registration

Thank you for your interest in serving as a mentor with the EFE Mentorship Program

Your answers will be kept strictly confidential. We will use this information to select mentors in addition to measuring the program’s effectiveness and improving future programs.

This information in aggregate, and without including your personal information, may be analyzed or included in reports that are published or sent to donors. If you have any questions or concerns about this questionnaire, please contact us at evaluation@efe.org.