Mentor Registration Survey

I wish to apply to be a London Excellence Mentor.

1. I understand that I will be asked to pay a non-refundable registration fee.
The registration fee is £65+vat for Ambassadors for Excellence, £95+vat for others*.

London Excellence will provide a half-day workshop to introduce the role and refresh your skills.

You will be provided with a certificate of attendance at the workshop that can contribute to a portfolio of evidence should you wish to work towards a qualification in coaching and mentoring.

Attendance at the workshop does not guarantee that you will be accepted as a London Excellence Mentor. Nor can we guarantee that we can match you immediately with an appropriate mentee.

If you agree to act as a mentor you must be prepared to commit to the relationship. This will nomally include supporting the mentee through six 90-minute sessions over a 6-month period - although this may vary if agreed between yourself and your mentee.

* Special introductory fees for the pilot programme

I understand that I will be asked to pay a non-refundable registration fee. The registration fee is £65+vat for Ambassadors for Excellence, £95+vat for others*. London Excellence will provide a half-day workshop to introduce the role and refresh your skills. You will be provided with a certificate of attendance at the workshop that can contribute to a portfolio of evidence should you wish to work towards a qualification in coaching and mentoring. Attendance at the workshop does not guarantee that you will be accepted as a London Excellence Mentor. Nor can we guarantee that we can match you immediately with an appropriate mentee. If you agree to act as a mentor you must be prepared to commit to the relationship. This will nomally include supporting the mentee through six 90-minute sessions over a 6-month period - although this may vary if agreed between yourself and your mentee. * Special introductory fees for the pilot programme I agree

2. Please enter your:

Please enter your: First Name
Surname
Job Role
Company
Email
Telephone Number

3. I have experience in the:

	No experience	Some experience	Extensive experience
Public sector	* I have experience in the: Public sector No experience	Public sector Some experience	Public sector Extensive experience
Private sector	Private sector No experience	Private sector Some experience	Private sector Extensive experience
Not-for-profit sector	Not-for-profit sector No experience	Not-for-profit sector Some experience	Not-for-profit sector Extensive experience

4. I have experience in organisations employing:

	No experience	Some experience	Extensive experience
1 - 25 people	*I have experience in organisations employing: 1 - 25 people No experience	1 - 25 people Some experience	1 - 25 people Extensive experience
26 - 50 people	26 - 50 people No experience	26 - 50 people Some experience	26 - 50 people Extensive experience
51 - 250 people	51 - 250 people No experience	51 - 250 people Some experience	51 - 250 people Extensive experience
251 - 1000 people	251 - 1000 people No experience	251 - 1000 people Some experience	251 - 1000 people Extensive experience
>1000 people	>1000 people No experience	>1000 people Some experience	>1000 people Extensive experience

5. I have personal experience of leading / managing:

	No experience	Some experience	Extensive experience
1 - 10 people	*I have personal experience of leading / managing: 1 - 10 people No experience	1 - 10 people Some experience	1 - 10 people Extensive experience
11 - 50 people	11 - 50 people No experience	11 - 50 people Some experience	11 - 50 people Extensive experience
51 - 250 people	51 - 250 people No experience	51 - 250 people Some experience	51 - 250 people Extensive experience
251 - 1000 people	251 - 1000 people No experience	251 - 1000 people Some experience	251 - 1000 people Extensive experience
>1000 people	>1000 people No experience	>1000 people Some experience	>1000 people Extensive experience

6. I have personal experience of managing budgets in excess of:

	No experience	Some experience	Extensive experience
£100,000	*I have personal experience of managing budgets in excess of: £100,000 No experience	£100,000 Some experience	£100,000 Extensive experience
£250,000	£250,000 No experience	£250,000 Some experience	£250,000 Extensive experience
£500,000	£500,000 No experience	£500,000 Some experience	£500,000 Extensive experience
£1 million	£1 million No experience	£1 million Some experience	£1 million Extensive experience
£10 million	£10 million No experience	£10 million Some experience	£10 million Extensive experience

7. I feel confident to mentor someone who wishes to improve their organisation's:

	No thank you	Confident	Very confident
Customer focus	*I feel confident to mentor someone who wishes to improve their organisation's: Customer focus No thank you	Customer focus Confident	Customer focus Very confident
Innovation and creativity	Innovation and creativity No thank you	Innovation and creativity Confident	Innovation and creativity Very confident
Strategic direction / leadership	Strategic direction / leadership No thank you	Strategic direction / leadership Confident	Strategic direction / leadership Very confident
Partnerships with other organisations	Partnerships with other organisations No thank you	Partnerships with other organisations Confident	Partnerships with other organisations Very confident
Management systems	Management systems No thank you	Management systems Confident	Management systems Very confident
Management of their people	Management of their people No thank you	Management of their people Confident	Management of their people Very confident
Performance & growth	Performance & growth No thank you	Performance & growth Confident	Performance & growth Very confident
Sustainability & corporate responsibility	Sustainability & corporate responsibility No thank you	Sustainability & corporate responsibility Confident	Sustainability & corporate responsibility Very confident

8. I feel confident to mentor someone who wishes to explore their:

	No thank you	Confident	Very confident
Career direction	*I feel confident to mentor someone who wishes to explore their: Career direction No thank you	Career direction Confident	Career direction Very confident
Transition into a new role	Transition into a new role No thank you	Transition into a new role Confident	Transition into a new role Very confident

Other (please specify)

9. Please tell us what you feel that you can bring to a mentoring relationship in terms of knowledge, skills, behaviours and networks.

Please tell us what you feel that you can bring to a mentoring relationship in terms of knowledge, skills, behaviours and networks.

10. I can attend a half-day workshop on:

I can attend a half-day workshop on: 16th July 2012 (am)

Please keep me on your list for future workshops

Mentor Registration
Exit this survey

London Excellence Mentor Application

Mentor RegistrationExit this survey

London Excellence Mentor Application

Mentor Registration
Exit this survey