Mentorship Application

Account

Please enter a Username to create an account. If you already have an account please login before completing this form.

Username *

Check Availability
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Personal Details
Just a few personal details and we’ll have all the info we need.

Email (Personal) *

First Name *

Last Name *

Job Title *

(Current or Most Recent)

LinkedIn Profile *

Phone *

Goals & Interests
Complete the information below to help place you and find the best match in the program.

What role best describes you? *

Mentor

Mentor/Pod Leader

Mentee

Mentor & Mentee

Why do you want to be a part of the program? *

What are some goals you hope to achieve from the program? *

What areas are of interest to you? *

Digital & Programmatic

Social

Creative & Branding

Sales & Partnerships

Business Development

Planning, Operations, Client Services

Publishing

Technology

Data

If Other, please specify (help/support areas)

Experience

How many years of experience do you have? *

College Student

1-4 Years (Associates, Directors, Managers, AE’s, Senior AE’s)

5-10 Years (Senior Managers, VP, SVP)

10+ Years or C-Suite (EVP, Partner, CRO, COO, CEO)

Program Agreement

If accepted into the program *

I understand I must agree to the following

Participate for the full duration of the program for at least 10 Months
Meet with Designated “Pod” (Mentors/Mentees) at least once a month
Attend at least one 212NYC or industry event together (virtual or in-person) Per Quarter during the duration of their program
Commit to contributing to the overall digital advertising community and not just use the Mentorship Program to find a new job or sales leads (this isn’t the program’s primary objective)

Mentorship Application