Mentoring Program Application Application for individuals interested in being a mentor or mentee. Name First Last Email Pronouns Name of College/University Location (City, State) Degree (ex. MSW, MA Counseling, PhD. in Higher Ed) Certifications (ex. LPC, JD, LMSW, NCC) I'm interest in being a: Mentee Mentor Select your role: Non-Clinical Case Manager Clinical Case Manager Hybrid If you are a hybrid Case Manager, please indicate which type of CM you'd prefer to be matched with if other hybrid CMs are not available for matching: Non-Clinical Case Manager Clinical Case Manager How many years of experience do you have as a Higher Education Case Manager? How long have you been a member of HECMA? Do you have a particular mentor or mentee with whom you would like to be paired? If so, please list here: Please share any areas of specific responsibility, expertise, and/or interest that you have. (ex. mental health, homelessness, food insecurity, autism spectrum disorders, survivor advocacy, veterans, Title IX, etc.)Please tell us a little bit about your HECM experience and/or your future career goals:Section BreakHave you served as a mentor before? Yes No How can the Leadership team support you as a mentor?Section BreakAs a mentee, what are your primary needs/goals/areas of concern or interest?