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Mentor Connect | Become a Mentee

Mentee EOI application

Mentee Expression of Interest

Applicant Details:

First Name

Last Name

Email*

Phone

Current/most recent role and title?

Current Employer (if applicable):

How many years have you been in current role to date?

Application Information

Business Industry:

Please nominate the industry segment and role that best matches your business and current position.

Industry Segment

Industry Other...

Role

Role other...

Business Owners

If you own a business, please nominate your business structure

Is your business home based?

Describe your business or employment

What other professional disciplines/functions do you have experience in, either here or with other employers?

_________________________________

Other mentoring fields...

Why are you interested in being a mentee?

Everyone seeks mentoring for a variety of reasons. Please give us an insight into why you would like to be considered a mentee in this program.

Do you have a current National Police Clearance?

Do you have a current Working With Children check?

If not, are you prepared to apply for these documents?

I can provide a photograph of myself for the Mentor Connect program...

Mentee Declaration | By submitting an expression of interest to be a mentee, I acknowledge and accept the following:

1. I have read and understood the mentoring program guidelines

2. I understand WiBRD can take no responsibility for any advice or information exchanged between myself and a mentee or a mentor

3. My name, preferred contact details, professional photograph and employment details will be made available to my mentor as a part of this program

4. I will discuss and complete a mentoring agreement with my mentor to help ensure clarity and shared expectations.

5. I will treat in the strictest confidence all information and matters discussed in a mentoring relationship with a mentor.

6. I will provide feedback as requested to enable effective evaluation of the WiBRD Mentor Connect program

Please verify your request*

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Executive Officer
Jacinta Jones
[email protected]
0408 138 127

PO BOX 9432 | Mount Gambier West | SA | 5291