ATD MEMBER-ONLY TEMPLATES AND TOOLS

Mentee Application

Name:

Position/Title:

Series/Job Title:

Contact Information:

Department:

Location:

Length of Time in the Workforce:

Time at Company:

Length in Current Position:

Certifications:

Description of Present Duties and Responsibilities:

© ATD. This tool is from ATD’s course Creating Leadership Development Programs.
Find more tools at td.org/MemberTools.
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ATD MEMBER-ONLY TEMPLATES AND TOOLS

Mentee Application

Professional Experience
Series/Positions
Position Title Organization Dates of Service
Held

Self-Development Efforts to Date

Identify membership in professional/civic/other organizations, internships, professional awards and
recognition, academic awards, self-study, team assignments, and other developmental assignments.

Self-Understanding
Describe the characteristics that you possess that make you a likely candidate for this program.

© ATD. This tool is from ATD’s course Creating Leadership Development Programs.
Find more tools at td.org/MemberTools.
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ATD MEMBER-ONLY TEMPLATES AND TOOLS

Mentee Application

Time Investment
Describe the amount of time you anticipate investing with your mentor and in assignments. How will
you cover work-related duties and assignments?

Requested Mentor Qualifications

Describe what you are looking for in a mentor.

© ATD. This tool is from ATD’s course Creating Leadership Development Programs.
Find more tools at td.org/MemberTools.
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ATD MEMBER-ONLY TEMPLATES AND TOOLS

Mentee Application

Proposed Objectives
Describe what you hope to accomplish with an assigned mentor. Identify learning experiences,
feedback you desire, observations you’d like to make, skills you wish to acquire, and knowledge you’d
like to gain.

Benefit
Describe the benefit to the company and benefit to you and your career.

Applicant Signature:

Date:

© ATD. This tool is from ATD’s course Creating Leadership Development Programs.
Find more tools at td.org/MemberTools.
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ATD MEMBER-ONLY TEMPLATES AND TOOLS

Mentee Application

Supervisor Endorsement
This endorsement should include examples describing the candidate’s achievements and
qualifications, how a mentor will benefit the employee, and how the results support the corporate
mission. Discuss the candidate’s leadership and teaming skills, performance results, interpersonal
skills, and technical competence.

Supervisor’s Signature:

Date:

© ATD. This tool is from ATD’s course Creating Leadership Development Programs.
Find more tools at td.org/MemberTools.
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ATD MEMBER-ONLY TEMPLATES AND TOOLS

Mentee Application

Decision
 Approved

Mentor Assigned:

 Disapproved

Comments:

Talent Manager Signature:

Date:

Adapted from ebb associates.

© ATD. This tool is from ATD’s course Creating Leadership Development Programs.
Find more tools at td.org/MemberTools.
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