ACHE-TENC - ACHE-TENC 2026 Mentorship Application

* Name

* Email Address

Phone Number

Employer

Title

* Are you a current ACHE & ACHE-TENC chapter member in good standing (i.e. 2026 membership dues are paid)?

Yes
No

* What is your current membership status in the American College of Healthcare Executives?

Member
Fellow (FACHE)
Student Associate

* Are you interested in participating in the ACHE-TENC 2026 Mentorship Program as a:

Mentor
Mentee
Both Mentor and Mentee

* How many years of Healthcare Management experience do you have?

<5 years
6-10 years
10-15 years
15+ years

* How would you describe your professional level?

Senior Executive (VP, C-Suite)
Director
Mid-Careerist (established professional looking to transition to the next level, i.e. Director)
Early Careerist (under 40, typically graduated from a Master's program within the last 5 years)
Graduate Student (will graduate within one year)

Please list degrees, certifications, credentials.

* If a Mentor, what aspects of the current healthcare environment are you most involved in/have the most experience? If a Mentee, what aspects of the current healthcare environment are you most interested in? Please select top 3 options below.

If a Mentor or Mentee or Both, please provide any other information you feel would be important.

Please indicate how many protégés you would be interested in mentoring:

1
2

Mentee applicants range from Graduate Student to Senior Executive. Which professional level(s) are you interested in mentoring? I prefer a mentee who is a: (check all that apply)

Senior Executive
Mid-Careerist
Early Careerist
Graduate Student

Do you prefer a Mentee from within your organization or from a different organization?

My organization
Another organization

Tell us what you are looking for in a Mentor/Mentee relationship, as a Mentor. This helps us with the Mentor/Mentee matching process.

In submitting this application I understand that, if selected as a Mentor, I am committing to:

A 6 month Mentorship Program that requires availability April - September, 2026
16 contact hours (face-to-face or virtual, for MENTORS only)
Participate in orientation on March 26, 2026 5:00pm-6:30pm
Participate in a closing banquet on October 8, 2026
Complete the survey at the end of the Mentorship program

What are your career goals?

Are you interested in advancing to FACHE, and are you looking for a Mentor with FACHE status?

Yes
No
A mentor to help me with advancing to FACHE would be helpful, but not essential.

Do you prefer a Mentor from within your organization or from a different organization?

My organization
Another organization

Tell us what you are looking for in a Mentor/Mentee relationship, as a Mentee. This helps us with the Mentor/Mentee matching process.

Are there particular themes or topics you would find helpful focusing on? (e.g., grow, balance, network, lead, professional development, networking, tactical skills).

In submitting this application I understand that, if selected as a Mentee, I am committing to:

A 6-month Mentorship Program that requires availability April - September, 2026
16 contact hours (face-to-face or virtual, for MENTORS only)
Participate in orientation on March 26th, 2026 5:00pm - 6:30pm
Participate in a closing banquet on October 8, 2026
Complete the survey at the end of the Mentorship program

* Upload your cover letter or resume

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ACHE-TENC 2026 Mentorship Application

General Information

Mentor Applicants

If you are applying to be a Mentor, please address the questions below.

Mentee Applicants

If you are applying to be a Mentee, please address the questions below.