Peer Mentor Nomination

Peer Support is the cornerstone of Independent Living. We all need peers, even professionals! The IL-NET and APRIL would like to put out an opportunity for you to nominate someone in your network or at your CIL as a mentor. We are currently trying to increase the pool of mentors to be more diverse, and to really dive in deep to find those CILS and SILCs who are doing good work, but we just don't know about them yet! Mentors must have at least two years experience in the position they are mentoring as. Those who are nominated do not have to commit to anything right now. They will be followed up with by Mary Willard at APRIL to let them know they were nominated, what it means to be a mentor, and to interview them to find out more about their specialty area before adding them to the pool of mentor interviews for mentees to select from. If you would like to recognize someone who is doing innovative work, or someone who just is a solid professional who knows their job inside and out and has a lot to offer someone who is just learning, nominate them to be a mentor!

1. Please fill out your information below

First Name

Last Name

Title

Company Name

Street Address

State

Email Address

Phone Number

2. Who are you nominating as a Peer Mentor? Include their organization, city and state. Self-nominations are welcome.

3. Please place here any contact information you have for your nominee:

4. What is the position in which they would be able to mentor?

Please enter an 'other' value for this selection.

5. Why do you think they would make a good mentor? Include any programs they run that you think are innovative or informal mentoring they may have done with others in your network you know of along with any other reasons you want to include here.