Statement of Intent to Use the Mentor Program Leader's Assessment by Mentors

International Mentoring Assoc. Since 1987, the premier source for support of mentoring.

Statement of Intent to Use the: Mentor Leader's Assessment Process

You should ONLY complete and submit this "Intention" form if you:

Are currently an IMA member at the "Program Leader Level"
Agree to work with IMA through the entire Leader's Assessment process, including:
- Complete the self-assessment
- Submit a list to IMA of all your mentors who are eligible to assess your leadership (Please send that list right away.)
- Send your mentors the letter that IMA will send you regarding this assessment process
- Reflect on and analyze the data submitted by your mentors which IMA will provide to you
- Set goals and develop a plan for your professional growth & improvement as a mentor program leader
- Collaborate with and be open to feed back and advice from the IMA person who facilitates your assessment process
Agree to implement the plan you develop as a result of this assessment for professional growth as a program leader.

I agree to the above terms and I understand the Mentor Program Leader's Assessment Process will be completely confidential for mentors and myself. Click here to ACCEPT >

Please complete the following form:

Your Name (required)

Your Position Title (required)

Your Responsibilities Relative to the Mentor Program (if above title is not sufficient to clarify that.)

Your email address (required)

Work Phone # (required)

Work Address (required)

City - State/Province - Postal/Zip Code (required)

Country - (required)
Other? >

Insert below any added comments IMA may need to conduct the assessment for you.

Click here ONCE to submit this form to IMA. Please wait a few seconds until the response page appears to confirm receipt of your information. Thanks. >

NOW, please send the list of your eligible mentors to IMA at

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However, you MAY copy this page, but only under the following conditions:

1. You retain all elements in this page as it prints out, including the web site banner, this copyright notice, and contact info.
2. You provide the information to others for free.
3. You do not sell this information or page, nor do you provide it to others along with services for which you are paid.

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Your Name (required)
Your Position Title (required)
Your Responsibilities Relative to the Mentor Program (if above title is not sufficient to clarify that.)
Your email address (required)
Work Phone # (required)
Work Address (required)
City - State/Province - Postal/Zip Code (required)
Country - (required)	Other? >