Herman A. Johnson Business Mentorship Mentor Application

Transcription

1 Minority Business Alliance 2600 Commerce Tower, 911 Main Street Kansas City, Missouri l 816/ Fax 816/ Herman A. Johnson Business ship Application Recruitment for the Herman A. Johnson Business ship is ongoing. However, application deadlines will be established, as the need arises, when classes are nearing capacity. MENTOR GUIDELINES Should be a veteran business owner, CEO, President or top level executive company must be a Chamber member in good standing at the time of application (For more information about Chamber membership, call 816/ ) Must have desire and ability to serve as a mentor for a CEO in the Greater Kansas City area Must actively participate in mentoring relationship and attend Herman A. Johnson Business ship meetings and events Must be willing to openly share business knowledge - both successes and failures 2010 MENTOR INFORMATION FORM Name: Title: Name of Business: Type of Business: Business Address: City State Zip Web site, if any: Business Business Phone: Fax: Home Address: City State Zip Home Phone: Cell: How did you hear about the Herman A. Johnson Business ship? A Chamber-led Collaboration

2 2010 ship Application (Please feel free to add additional businesses and information on a separate sheet) Number of years in business: Business Size - Number of Employees: Full Time Part Time Contractors Annual volume of business based on last fiscal year: $ Year Do you have / have you worked with a Board of Directors? Yes No Do you have / have you worked with an Advisory Board? Yes No Number of years in this company: Number of years in current position: Why are you interested in becoming a? (May be answered on separate page) Describe your s. How have they helped you? (May be answered on separate page) Describe any previous mentoring experience you have. (May be answered on separate page)

3 2010 ship Application What competencies and skills do you have that are valuable in a mentoring relationship? (May be answered on separate page) What do you feel is the most important skill or experience you have to offer another business owner? (May be answered on separate page) Please indicate whether the following are a strength (denote by 1 ), an aspect of the business that you cannot help with (denote by 2 ), an area that you are comfortable with that is not necessarily a strength or a need (denote by 3 ), or not applicable (denote by N/A ). This information will be one component considered in matching you with a business mentor. Marketing and Advertising Operations and Production Accounting and Financial Management Management and Leadership Personnel and Staffing Issues Business Expansion Developing/Modifying a Business Plan Strategic Planning Managing Inventory Other aspects (please specify) What are the three greatest mistakes you have made in business and what did you learn from each of them? (May be answered on separate page) 1) Lessons Learned 2) Lessons Learned 3) Lessons Learned

4 2010 ship Application What do you consider the largest success in your business career and how has this changed the way that you lead within a company? (May be answered on separate page) As a business leader, what have been your greatest strengths in moving the business forward? (May be answered on separate page) Why would you like to be involved with a program such as the Herman A Johnson Business ship? (May be answered on separate page) SIGNATURE I understand that as a I am volunteering my time to help advance area entrepreneurial leaders. It is the sole discretion of my assigned mentee and/or other Herman A. Johnson Business ship participants, mentors, mentees, administrators or Board members to take or not take any advice that I may give and I may not hold them responsible for the success or failure of any items or ideas which we discuss. I further understand that the Minority Business Alliance through the Herman A. Johnson Business ship reserves all rights to terminate my participation in the program at any time, and that I have no legal or equitable right to remain in the Herman A. Johnson Business ship program if my participation is terminated by the ship at any time. Similarly, I understand that I can terminate my participation in the Herman A. Johnson Business ship at any time. All information submitted on or with this Application is true, complete, and valid to the best of my knowledge and belief. Signed Print Name

5 2010 ship Application BUSINESS REFERENCES WORKSHEET (Please list three references that have known you in business.) Business Reference Address Contact Name Phone Relationship Business Reference Address Contact Name Phone Relationship Business Reference Address Contact Name Phone Relationship

6 General Release The undersigned,, (Applicant Name) on behalf of the signatory and, (Company Name) in consideration of services to be rendered by the Herman A. Johnson Business ship, a program sponsored by the Greater Kansas City Chamber of Commerce, through Minority Business Alliance, Inc. and POWER, does hereby forever release and discharge those parties set forth above as well as any person(s) participating as a formal or informal mentor of the program and agrees to defend them from liability, cause of action or other liability of any type, arising out of or in connection with any services rendered to the undersigned or to their business in connection with the mentoring program. Such services include any matter or thing emanating from or dealing with the mentoring program herinabove set out forever. This release shall be binding upon the signatories hereto, their respective assignees, transferees, heirs or any person, firm or corporation claiming by and through any of them. In witness whereof, the parties have duly signed this agreement of the dates indicated below. Applicant Signature Print Name Signature of Witness Print Name

7 Agreement for participation This letter sets forth the details of the agreement for participation in POWER (Partnering Organizations With Essential Resource), through the Herman A. Johnson Business ship. In consideration of the objective to enhance the business and economic development of (Mentee Business), the (Consultant) agrees to the following terms and conditions: To attend required quarterly meetings and training sessions; To mutually agree with business owner on the frequency and type of communications or meetings; To provide guidelines for the business owner s achievement of the goals and objectives as set forth in the SWOT (strength, weaknesses, opportunities, and threats) analysis; To commit to three year mentoring partnership; and To commit unwaveringly to completing and abiding by the confidentiality agreement. We trust that this opportunity through POWER will develop into a valuable business relationship for all parties. Business Consultant Companies interested in the Herman A. Johnson Business ship must be a member of the Greater Kansas City Chamber of Commerce at the time of application. For more information about Chamber membership, call (816)