CLA Mentorship Agreement Form

This agreement will serve as a tool and reminder to help build the expectations for both the mentor and mentee. Please complete this form by the end of your first session. The CLA Fellow Candidate is responsible for submitting this form.

* denotes a required field

Student/Mentor Information

Student First and Last Name *

Student Email *

Mentor First and Last Name *

Mentor Email *

Communication

Agreed-upon methods of communication (email/text/phone call/etc) *

Expectations of response time (be honest, realistic, and respectful!): *

Meeting Cadence

Meeting format and location (virtual/in-person/hybrid): *

What happens if one of us needs to cancel/rearrange: *

Goals

List two goals that you have for this mentoring relationship (e.g., gain perspective relative to skills necessary for success in academia, explore new career opportunities/alternatives, obtain knowledge of organizational culture, networking, leadership skill development, etc.)

Goal One: *

Goal Two: *

Agreement

As mentor and mentee, we are voluntarily entering into a mentoring relationship from which we expect mutual benefits and investment. We want this to be a rewarding, rich experience with our time together focused on professional/personal/academic development and the growth of our relationship. With this goal in mind, we have agreed upon the terms and conditions of our relationship as outlined in this agreement.

We are committed to frequent, open, and honest communication in this partnership. We will discuss and attempt to resolve any conflicts as they arise. If, however, one of us needs to terminate the relationship for any reason, we agree to abide by one another’s decision.

Student Signature *

Entering your name below will serve as the official signature of your commitment to this agreement.

First and Last Name *

Date *

Mentor Signature *

Entering your name below will serve as the official signature of your commitment to this agreement.

First and Last Name *

Date *

Human Verification *

Page last modified July 9, 2024

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