Application for Mentors 2018

First Name *

Last Name *

Month

Day

Year

Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Email *

Please tell us which GDST school you attended. *

Social Media

We hope to use social media platforms during the scheme. Please indicate which of the following you use for professional purposes.

Please give details of the Twitter handle or LinkedIn name that you use

Please tell us your current employer

Please tell us about your current position or job title

Date you started (an estimate is OK)

Month

Day

Year

This section is to help us learn more about your transferable skills and experience and will aid the matching process.

Have you previously been a coach or mentor? *

Coach

Mentor

Both

Neither

If you have previous experience as a mentor or coach and feel additional information about this would be helpful, please give details below (not essential)

Key Achievements

Please describe up to three key achievements in your professional or personal life.

Please select in which of the following you feel you would be able to help mentor someone *

Other: Please use this box to expand on or add additional areas not covered by the above list, including if relevant, industry specific expertise.

Please tell us if you have experience of working with difficult situations or people with special needs or considerations

Have you ever been on a career break? *

Please select as appropriate - this information may be helpful for accurate matching.

No

Yes - maternity leave

Yes - longer term break to raise children

Yes - redundancy

Yes - ill health

Yes - travelling or living overseas

Yes - to be a carer

Yes - other (please use box below)

Please use this box if you would like to add further detail on your career break, or if the reason for your career break is not in the list above.

We would hope that with six meetings anticipated over six months, mentors and mentees would be reasonably flexible about meeting times. However, if there are times (for example weekday evenings, weekends) when you are absolutely not available then please note here.

Mentors and mentees ideally will be able to meet face-to-face during the scheme, though this is not essential. Please indicate whether you would be open to an e-mentoring partnership *

Yes to e-mentoring

No to e-mentoring

Please use this box if you would like to add any further information either relating to your experience or the matching process.

If it isn't possible to match you on this occasion, we would love to be able to keep your information on file for future schemes. Please let us know if you are happy for us to do so. *

Yes, please keep my information for future schemes.

No, I'd like to register for the 2018 scheme only.

Data Protection

To enhance the mentoring experience and to create a supportive community, we would like to share the email addresses of all participants with one another.

The information supplied will only be used for the purposes of running and reviewing the scheme and for planning future alumnae initiatives.

Otherwise, your information will not be shared or divulged to any other person or organisation outside of the mentoring group, the GDST, its schools or organisations working on our behalf.

Before submitting your application, please ensure you have read the Mentoring Charter.

Please tick the boxes below to confirm: *

I consent to my information being used in the way described above

I will not divulge any information about individuals or their contact details obtained through the mentoring scheme to any third party.

I have read and understood the Mentoring Charter.

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Application for Mentors 2018

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Application for Mentors 2018

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