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* 1. First name

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* 2. Last name

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* 3. Email

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* 4. Company

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* 5. Job title

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* 6. Would you prefer to take part as a mentor in Summer or Autumn?

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* 7. Mentor training - for Summer, which dates are you available for? All sessions take place 2-4.30pm (You'll only attend 1 session but please say Yes to as many options as possible as we'll choose the most popular dates). For Autumn, we will arrange with you separately.

  Yes No If needs be
Tue 27 May 2-4.30pm
Wed 28 May 2-4.30pm
Thur 29 May 2-4.30pm
Fri 30 May 2-4.30pm
Mon 2 June 2-4.30pm
Tue 3 June 2-4.30pm
Wed 4 June 2-4.30pm
Thur 5 June 2-4.30pm
Fri 6 June 2-4.30pm

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* 8. Autumn Programme - which dates are you available for? (You'll attend 1 hour a week over 4 weeks, on the same day/time each week. Please say Yes as many options as possible so we can find the best dates for everyone.)

  Yes No If needs be
3.30-4.30pm on Mondays (3, 10, 17, 24 November)
3.30-4.30pm on Tuesdays (14, 11, 18, 25 November)
3.30-4.30pm on Wednesdays (5, 12, 19, 26 November)
3.30-4.30pm on Thursdays (6, 13, 20, 27 November)
3.30-4.30pm on Fridays (7, 14, 21, 28 November)

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* 9. Summer Programme - which dates are you available for? (You'll attend 1 hour a week over 4 weeks, on the same day/time each week. Please say Yes as many options as possible so we can find the best dates for everyone.)

  Yes No If needs be
3.30-4.30pm on Mondays (9, 16, 23, 30 June)
3.30-4.30pm on Tuesdays (10, 17, 24 June, 1 July)
3.30-4.30pm on Wednesdays (11, 18, 25 June, 2 July)
3.30-4.30pm on Thursdays (12, 19, 26 June, 3 July)

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* 10. Please state any dates that you'd need to miss

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* 11. Why would you like to take part in the programme?

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* 12. Rate your skills on scale of 1-10, where 1 is 'skill not developed' and 10 is 'skill completely developed'. (The We Speak mentor training will help you develop these skills so it's useful to know your assessment of this)

  1 2 3 4 5 6 7 8 9 10
Active listening
Asking open questions
Giving supportive feedback
Helping others build their confidence

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* 13. Are you happy for We Speak to email you with updates including social impact of the work you're doing or any We Speak opportunities you may be interested in. We will process your data in accordance with our privacy policy (www.wespeak.co/privacy-policy). You can withdraw consent any time by emailing laura@wespeak.co, or clicking unsubscribe on communications

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* 14. Are you happy for us to use screenshots and videos for promotional purposes? (Tick as appropriate)

  Yes No
Yes, I am happy for you to use screenshots
Yes, I am happy for you to use videos
Yes, I am happy for you to use my name next to quotes
Yes, I am happy for you to use my name next to screenshots

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* 15. In week 3 students submit questions they have about the topic of job interviews. We ask mentors to share their advice about job interviews and anonymously compile all the information for the students. Are you happy for us to share your anonomised advice?

  Yes No
Yes, I am happy for you to share my advice
This might include but is not limited to the right to use them in our printed and online publicity, social media and programme material. We will process your data in line with our privacy policy (www.wespeak.co/privacy-policy). You can withdraw your consent at any time by emailing laura@wespeak.co

By submitting this form you are agreeing that We Speak will contact you about the We Speak programme, that we can record sessions for safeguarding and evaluation purposes, that we can take quotations from feedback and sessions to be published anonymously to promote We Speak's work, and you agree that we will process your data in line with our privacy policy (www.wespeak.co/privacy-policy). We will keep information for a reasonable period.

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