Thank you for applying to become a GEM Mentor to support sector colleagues within learning, engagement and interpretation roles.

Please complete this application form as fully as possible. 

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* 1. Please provide your full contact details

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* 2. Are you a personal or institutional GEM member

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* 3. If yes, please provide your membership number

Each applicant is invited to offer a maximum of 50 words for each question below:

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* 4. Tell us a little bit about yourself (this may be used to create a short mentor's bio)

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* 5. What will you bring to the mentoring programme?

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* 6. What skills / areas of experience do you do you feel you can offer? (tick all that apply)

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* 7. What stage of your career do you believe yourself to have reached?

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* 8. What topics/areas are you particularly keen to support mentees in?

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* 9. Mentoring can be undertaken in person or virtually (e.g. via Zoom), please indicate if would like to mentor someone ...

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* 10. On a scale of 1-10, where 10 is the high score, how confident do you feel in coaching and mentoring skills?

0 5 10
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i We adjusted the number you entered based on the slider’s scale.
Then ... 

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* 11. Are there any potential barriers to your participation?

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* 12. If you require reasonable adjustments to support your application and/or to participate in being a mentor as fully as possible, please tell us more.

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* 13. Is there any additional support that you would like to help you as a mentor?

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* 14. Some mentees ask for mentors who have lived experience within our sector (e.g. a Person of Colour, Queer, etc.). If you have lived experience and are willing to support a mentee in this way, please do tell us in what context you might be able to help.

This programme is funded by Arts Council England. Please complete the following short questionnaire.

The information provided below will only be used in the following ways:
(a) within reports to ACE in line with their funding requirements.
(b) where mentees have specifically asked in their applications to be mentored by someone with similar gender, ethnicity identities, etc.. 

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* 15. I identify as 

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* 16. How would you describe your ethnicity?

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* 17. How old are you?

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* 18. Do you consider yourself to have a disability or long-term illness?

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* 19. Do you consider yourself to be neurodivergent?

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* 20. If you live and/or work in a Levelling Up for Culture area as defined by Arts Council England please tell us which one. If you are unsure please visit ACE Levelling Up for Culture Places

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