Name: National Chimney Sweep Guild
Price range: $

Mentor Connect – ft. TBD (April 7, 2026)

First and Last Name

Organization

Position/Title

Email Address

Phone Number

Please share which topic(s) you are most interested in discussing.

Examples may include: technical, business, professional development, health & safety, codes & standards, customer service, marketing & sales, technology, etc.

Confidentiality Statement

For a mentoring relationship to develop, participants must feel that discussions of private issues or problems are being handled with discretion. The purpose of this agreement is to protect attendees from a breach of confidentiality during the event.

I agree to keep confidential the specifics of my discussions with my mentor and fellow mentees unless given permission to share this information with others. I am also encouraged to discuss any concerns I have about my mentoring experience with the program coordinator, Brittney Burton, at bburton@ncsg.org or 317-837-1500. The program coordinator will maintain confidentiality unless a breach of confidentiality is necessary to maintain someone’s personal safety. I understand that all individuals participating in the NCSG Mentor Connect program are required to agree to this Confidentiality Statement.

Antitrust Agreement

I agree to comply with antitrust laws and understand that discussions of agreements or coordinated actions that could restrain competition are not permitted, including conversations about individual company prices, rates, or market practices.