Philippine Nurses Assocation of America: Patnubay sa Pagtatagumpay Program (P3) Mentee Application

Mentee Application

A candidate for mentee must satisfy the following requirements:

1. PNAA membership is active and in good standing

2. Hold a current, active, unrestricted RN License in a state or territory of the United States or another country.

3. Willingness and readiness to be mentored as evidenced by completed Mentor-Mentee Agreement.

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* 1. Applicant's Demographic Questions

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Highest Level of Education

Bachelor Degree

Master's Degree

Doctoral Degree

Post-Doctoral Fellowship

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* 3. As a mentee, what is/are your main goal(s) in participating in the PNAA Patnubay sa Pagtagumpay Program (P3)?

Advice on independent work habits (work-life balance, resilience, etc.)

Advice on team skills

Career Guidance (moving to the next level in the organization)

Career Guidance (transitioning to another work/ specialty)

Certification Preparation

Networking Opportunities

Others

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* 4. What certification would you like to pursue next year?

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* 5. What learning needs/professional gaps/educational topics would you like to be addressed throughout the mentorship program? List your three priorities.

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* 6. How long have you been part of a mentoring relationship, either as a mentor or mentee

I've never been before

less than 6 months

6 months-1 year

1- 2 years

3-5 years

more than 5 years

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* 7. Please upload your current Curriculum Vitae/Resume here:

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 8. Upload Your Head Photo Here

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.