Mentee Application Form

Please tell us about your role and your organisation. If relevant, include details of your department, business area and management responsibilities. (max 200 words) *

What areas of work would you wish to be included which would allow you to develop your skills and confidence in your work practice? *

What specific learning goals/objectives would you like to achieve and how might a mentor help you achieve these? *

What are you looking for in a mentor in terms of experience, knowledge, skills or approach?

Are there any geographical or time restrictions on your participation?

Are there any other requirements we need to be aware of?

I understand that to be involved, I have to commit to the following:

  • Participating in the evaluation of the programme
  • Any confidentiality requirements as agreed with my mentor

I agree that this application will be viewed by the Mentoring co-ordinator for the matching process and will be shared with my proposed mentor.

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