Mini Mentoring Mentees Application Form 2022-2023

Name

First Last

Your current position and organisation

How long have you been in post

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Phone

Career Summary

Please provide a career summary in the following format: Date, Job Title, and Organisation

Mini Mentoring offers role to role support – what areas of expertise are you looking for support on (up to three) that you would like to cover with your mentor?

What are your reasons for seeking short term mentoring at this time i.e. you may be changing roles or taking on different/new responsibilities?

Have you been a mentee before, either formally or informally?

Are you willing/able to make time in your working schedule to meet your mentor?

Are you able to travel and potentially to cover the costs of travel to meet your mentor?

Do you have any additional support needs?

Do you have the support of your employer / manager (if applicable)?

Privacy Statement

Your personal information is important to us. The contents of this form are kept confidentially and will only be read by FST staff and your mentor/potential mentor. Any unsuccessful applications will be destroyed once the application process is complete. Successful applications will be kept on record for the duration of the programme and then destroyed. We keep details of the names of those who have been mentored for our records and we may approach you in the future, if successful, to ask for anonymous feedback on the medium-long term impact of the programme. If you would prefer us not to keep your name on record or to be contacted in this way, please let us know. Mentoring relationships are always confidential and we will not disclose the mentor/mentee relationship beyond FST.