Before you begin your application, please take a moment and look through the DBIA Mentors database to pick your top three choices for mentors based on your career interests and need. We can’t guarantee a match but will do our best to fulfill your request. Mentee must be a DBIA member in good standing.Name First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Which best describes you:StudentYoung ProfessionalIndustry Professional Young Professionals & Industry PractitionersCurrent Job TitleCredentials/LicensesCurrent EmployerEmployer Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Start DateFormat: MM/YYTotal Years of Industry Experience StudentsWhere are you currently enrolled?When will you graduate? Market Sectors Interest Aviation Civic/Assembly Commercial Buildings Educational Facilities Energy/Power Faith-Based Government — Federal/Military Government — Public Institutions Government — State/City/ County/Municipal Healthcare/Medical Facilities Hospitality Industrial, Process and/or Research Facilities Office Buildings Rehabilitation, Renovation and/ or Restoration Transportation (other than Aviation) Utility (other than Energy/Power or Water/Wastewater) Water/Wastewater Other (please specify below) Other Why/how did you choose your current career?Where do you want to go from here – what are your career goals?What are you currently doing to help move you towards your goal(s)?What obstacles have you faced that are preventing you from achieving your goal(s)?What do you believe you can do to help overcome your obstaclesHow do you envision a mentor assisting you in your career goals?Do you have any specific requests as it relates to an instructor (i.e., field of work, market sector, gender, etc.)? Please sign below your agreement and understanding of the following: As a mentee you are responsible for gaining your mentors’ trust and confidence by interacting morally, ethically, and collegially. You will value the mentor’s time, professional and personal commitments. Availability of mentors is based on demand. DBIA cannot guarantee that a mentor will be available immediately upon request and cannot guarantee that any specific requests noted above can be fulfilled. Once a mentor is selected, you hold primary responsibility for the initial outreach to and engagement of the mentor. The mentor/mentee relationship is for a one-year period and can only be extended upon written, mutual agreement of both the mentor and the mentee. SignatureDate Date Format: MM slash DD slash YYYY