Mentor Application || NEHERS

1. Personal Information

Name: *

Current Job Title: *

Company/Organization: *

Your Industry: *

Credentials: *

e.g. RFI, HERS Modeler, or HERS Rater certification, etc.

2. Contact Information

Address: *

City: *

State: *

Zip Code: *

Email Address: *

Phone Number:

3. Which type of Mentorship are you looking to provide?

Mentor Type: *

Rating Field Inspector (RFI)

Home Energy Raters (HERS) Modeler

4. Where are you based?

Location: *

Eastern MA (Boston Area)

Central MA (Worcester Area)

Western MA (Pioneer Valley)

Western MA (Berkshires)

5. How many years have you been working in the HERS Industry?

Experience: *

1 year

2 years

3 years

4 years

5 years

More than 5 years

6. Availability

Preferred Days/Times: *

7. What gender do you identify with?

Gender: *

Male

Female

Other

Prefer not to answer

Preferred Pronouns:

Optional

8. What is your age?

Age: *

Under 18

18 - 29

30 - 44

45 - 59

60 - 74

75 or over

9. Demographics (self-disclosed)

Demographics: *

BI-POC (Black, Indigenous or Person of Color)

Disabled

Female

Immigrant

LGBTQ

Low-Income

Single Mom/Parent

Veteran

White

Other:

10. Do you speak any languages in addition to English?

Other Languages: *

Yes

No

Language(s):

If so, what languages?

11. References

References: *
With Contact Information

Provide names/contact for 1 reference

12. How did you hear about the NEHERS Mentorship Program?

Hear About: *

Friend/Family/Acquaintance

Found on a HERS Industry-related Website (RESNET, NEHERS, etc.)

Found on Other Website (Indeed, ZipRecruiter or Others)

Trade Industry Journal (e.g JLC)

Construction Industry Contact/Co-Worker

School Guidance Counselor/Instructor

Other

Other:

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