The responses to the below questions will be used to assist with the process of suitably matching Mentors with Mentees.

Name

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Email address*

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Current QLD Web Member

Choose:

Yes

No

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Please select from the following:

I am applying to be a mentor

I am applying to be a mentee

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Background Information

Please list/summarise your career experience to date: *

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Have you previously been involved or are you currently participating in any other mentoring programs? If yes, please provide details. *

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Areas of Interest and Future Aspirations

What are your key areas of interest (i.e. work &/or study wise)? *

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Goals/Aims & Objectives

What goals and objectives are you hoping to achieve by participating in the QLD WEN Mentoring Program? *

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What are you most interested in learning or getting assistance from a Mentor about?

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Mentee applicant only: Briefly explain what your professional aspirations, career plans, etc. are for the next 1-5 years

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Preferences

What qualities would you ideally be looking for in a Mentor/Mentee?*

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Describe any desirable characteristics of your optimal Mentor/Mentee that you think might best meet your needs/preferences. *

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Do you have any preferred modes of liaising and working with your Mentor? (e.g. would you prefer engaging with your mentor predominantly via face to face meetings, email correspondence, phone calls &/or a combination of these, etc.)

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Any Other Relevant Information

Is there anything else/any other information of relevance that you would like to add? *

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If you have any questions, please send them to: wenmentoring@esaqld.org.au