Please fill out the application below.

If you need to save your application and complete at a later time, you can click the “Save for Later” tab at bottom of the page. You will need to submit your email address and setup a password in order to retrieve your application later. Please save your password as you will not be able to retrieve the information without it. If you need to go back and complete your saved application, simply click on the “Continue Saved Form” tab at the bottom of the page. You will have to enter your email address and password to continue your saved form.

If you have any questions or problems, please contact Jan Wehrman at 210.486.5904 or email

Mentor Application

Legal Business Name/d.b.a

SAePS Number

Business Address

Mailing Address

Web Address

Business Phone

Date Business Established and State of Formation or Incorporation

Fax Number

Owner Name and Title

Form of Business [corporation, partnership, etc.]

E-mail Address

Number of Full-time employees

Number of Part-time employees

In the last three (3) years, I have bid on City jobs as a

In the last three (3) years, I have been awarded City jobs as a

Participation in the City of San Antonio's Bonding Assistance and/or Mentor-Protégé Program is neither a guarantee of obtaining bonds or contracting opportunities, nor a promise of business. Rather, it is a means to foster positive, long-term, capacity-building skills for small business enterprises. The assistance provided by the Bonding Assistance/Mentor-Protégé Program affiliates is intended to improve business practices and offers no guarantee of financial gain.

Current Business Relationships

Name of Insurance Company


Type of Coverage

Agent Phone Number

Coverage Amount $ Single

Coverage Amount $ Aggregate

Name of Bonding Company

Surety Agent

Name of Surety

Agent Phone Number

Bond Line

Annual Business Volume

Current Bank

Credit Line

Name of Accountant

Accountant Phone Number

***Signature mandatory ***

Firm Representative (printed first and last name)

Signature of firm representative*:



*Signature certifies the firm representative identified is authorized to make decisions on behalf of the firm and agrees to attend all portions of this Program, without substitution. Signature also certifies that information on all corresponding pages and attachments is true and accurate. In addition, signature certifies Mentors and Protégés meet the qualifications listed in the Bonding Assistance & Mentor-Protégé Program Guide.

1. Provide a brief company summary, including company profile, general and specialized operational areas of expertise, historical and recent activities and accomplishments in support of S/M/WBEs, operating history, any prior Mentor/Protégé relationship, etc.

2. Describe how the company will provide the necessary time and resources to ensure a successful mentor/protégé relationship. If lacking a presence in the San Antonio Metropolitan Statistical Area (SAMSA), please list the communication channels to be used in meeting with a protégé if and when assigned one.

3. Has your firm been, or is your firm presently, involved in a mentor relationship? If so, please explain:

Applicant Assessment

Mentor applicants : Check the areas of expertise in which you wish to provide assistance:

Other areas of expertise