EIANZ WA Division 2024 Mentoring Survey | Mentee

Thank you for expressing an interest in becoming a mentee in the EIANZ WA Division 2024 Mentoring Program.

Mentors and mentees will be matched based on the information provided in this expression of interest and after a speed dating matching event. Placement on the program cannot be guaranteed.

The mentoring program coordinator may contact you to discuss your expression of interest or request further information to assist in the matching process.

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* 1. Contact Details

Name

Position title

Organisation

Email address

Work phone number

Mobile phone number

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* 2. What would you like to achieve by participating in the Mentoring Program? Consider in terms of your current role and career development. eg. networking opportunities, career guidance/goal setting, decision making, communication, understanding the public/private sector or stakeholders, etc.

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* 3. Please describe any previous involvement in formal or informal mentoring relationships (if applicable):

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* 4. Please provide a short overview of your qualifications, work history, skills and experience:

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* 5. Please provide a short overview of the learning and development activities (professional and/or extra-curricular) you have undertaken in the last 12 months:

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* 6. Please write a bio which will be used in the speed matching information booklet (max 100 words)

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* 7. Overall, please list the 3 things you will bring as a mentee to the Mentoring Program.

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* 8. Please indicate if you prefer a mentor from the following categories. (whilst every effort will be made to match mentees based on their preferences, this cannot be guaranteed).

Male

Female

Experience level | Early in career

Experience level | Established career

I am happy to be matched with any suitable mentor

Culturally diverse (please specify)

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* 9. Please provide any other relevant information to support your application

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* 10. Mentee's agreement
By expressing interest in the WA Division 2024 Mentoring Program, I agree / acknowledge the following (please read all statements below and tick check boxes to agree).

The information contained on this form will be used for matching purposes

Every effort will be made to match me with a suitable mentor based on my skills, objectives and preferences. However, matching and placement on the program cannot be guaranteed

Abide by the Mentoring Guidelines and maintain confidentiality with my mentor and other program participants

Drive the relationship including scheduling meetings with my mentor as negotiated

Maintain open and honest communication with my mentor

Maintain contact with the Mentoring Program coordinator

Attend any events associated with the program

Participate in an evaluation of the program

EIANZ WA Division 2024 Mentoring Survey | Mentee

Question Title

* 1. Contact Details

Question Title

* 2. What would you like to achieve by participating in the Mentoring Program? Consider in terms of your current role and career development. eg. networking opportunities, career guidance/goal setting, decision making, communication, understanding the public/private sector or stakeholders, etc.

Question Title

* 3. Please describe any previous involvement in formal or informal mentoring relationships (if applicable):

Question Title

* 4. Please provide a short overview of your qualifications, work history, skills and experience:

Question Title

* 5. Please provide a short overview of the learning and development activities (professional and/or extra-curricular) you have undertaken in the last 12 months:

Question Title

* 6. Please write a bio which will be used in the speed matching information booklet (max 100 words)

Question Title

* 7. Overall, please list the 3 things you will bring as a mentee to the Mentoring Program.

Question Title

* 8. Please indicate if you prefer a mentor from the following categories. (whilst every effort will be made to match mentees based on their preferences, this cannot be guaranteed).

Question Title

* 9. Please provide any other relevant information to support your application

Question Title

* 10. Mentee's agreementBy expressing interest in the WA Division 2024 Mentoring Program, I agree / acknowledge the following (please read all statements below and tick check boxes to agree).

* 10. Mentee's agreement
By expressing interest in the WA Division 2024 Mentoring Program, I agree / acknowledge the following (please read all statements below and tick check boxes to agree).