Thank you for your interest in becoming a Stronger Nurse Mentor. Your experience and guidance can help shape the next generation of nurses and create a stronger world.

Full Name *

Email *

Phone *

City *

State *

Preferred Contact Method *

Nursing Background *

Registered Nurse (RN) – Active

Registered Nurse (RN) – Retired

Licensed Practical Nurse (LPN) – Active

Licensed Practical Nurse (LPN) – Retired

Advanced Practice Nurse (APRN, NP, CNS, etc.) – Active

Advanced Practice Nurse (APRN) – Retired

Other (please specify)

Current Nursing License & Status

Nursing License Number *

State(s) Where Licensed *

Years of Nursing Experience *

Primary Nursing Specialty or Setting *

Example: Bedside care (ICU, medical-surgical), community health, leadership, travel nursing, entrepreneurship, etc.

Other Relevant Healthcare or Mentoring Experience *

Share any other skills, certifications, or experience mentoring that would be relevant.

Mentorship Interest & Committment

What Type of Mentoring Are You Interested In? *

One-on-one mentoring – Regular guidance with one nursing student

Group mentoring – Sharing wisdom with small groups of nurses or students

Virtual mentoring – Remote connection via phone, email, or video call

In-person mentoring – Meeting locally (if available in my area)

Topic-specific guidance – Focused mentoring on specific topics (e.g., financial literacy, career navigation, wellness, leadership, entrepreneurship)

Time Commitment & Availability *

How much time per month can you realistically commit to mentoring? *

What is your preferred mentoring frequency? *

Weekly check-ins

Bi-weekly check-ins

Monthly check-ins

Flexible/ad-hoc

Which of the following times work best for you? *

Mentorship Interest & Committment

What draws you to mentor aspiring or early-career nurses? *

Share your motivation and what you hope to give back.

What are 2–3 key areas where you can offer guidance or support? *

Examples: clinical skills, career planning, financial management, work-life balance, navigating burnout, leadership, specialty-specific advice, entrepreneurship, etc.

How would you describe your mentoring style? *

Are you directive, collaborative, encouraging, action-oriented, etc.? What has worked well in the past?

Have you mentored others before?

If yes, briefly describe that experience:

Alignment with Stronger Nurse Mission

Understanding Our Mission *

What does "a stronger nurse creates a stronger world" mean to you?

Who do you want to support through mentoring? *

Single mothers or primary caregivers in nursing

First-generation college/nursing students

Low-income or under-resourced aspiring nurses

Nurses from historically marginalized communities

Career-changers or non-traditional students

Nurses seeking to advance (ADN→BSN, BSN→MSN, specialty, leadership)

Nurses experiencing burnout or seeking wellness support

All of the above

Alignment with Stronger Nurse Mission

What does commitment to equity and inclusion in nursing mean to you? *

Mentor Training & Support

Are you willing to participate in mentor training or orientation?

What kind of ongoing support would be most helpful to you?

Monthly mentor community calls or check-ins

Mentor resource library (articles, guides, tools)

One-on-one coaching or support

Mentor peer group (connecting with other mentors)

Feedback from mentee or program coordinator

Background & Safety

Background Screening *

Are you willing to participate in a basic background screening process?

Have you ever been disciplined by a nursing board or professional licensing body *

How Did You Hear About This Opportunity? *

Additional Comments or Questions

Is there anything else you'd like us to know about you, your mentoring interests, or questions about the program?

Mentor Expectations

By becoming a Stronger Nurse Mentor, you agree to:

Respect the confidentiality and privacy of your mentee
Maintain regular, consistent contact as agreed
Provide honest, supportive, and non-judgmental guidance
Model professional integrity and commitment to nursing excellence
Support mentees in their journey without imposing your path
Communicate promptly if you need to pause or end the mentoring relationship
Participate in mentor training and onboarding (if provided)
Align with Stronger Nurse Stronger World's mission and values

By submitting this application, you confirm that:

All information provided is true and accurate

You have read and agree with the mentor expectations and agreement above
You understand that this is a volunteer role and is unpaid
You consent to be contacted by Stronger Nurse Stronger World regarding this application
You agree to receive updates about the mentorship program and Stronger Nurse Stronger World's mission and work
You understand that Stronger Nurse Stronger World may share your application with the Mentor Selection Committee

Captcha

Mentorship Interest & Committment

Mentorship Interest & Committment

Alignment with Stronger Nurse Mission

Alignment with Stronger Nurse Mission

Background & Safety

Program Consent & Communication