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E-mentoring

Thank you for applying to join one of the LCEBA Mentoring programmes. Please complete this form fully. The information supplied on your experience and background will be used to provide the best mentor and student match possible. All information given on this form is confidential.

 

This project has been part financed by the European Union through the Social Fund - helping develop employment by promoting employability, business spirit, equal opportunities and investing in human resources. The local Learning and Skills Council also fund the E-mentoring project.

     
 

What are you applying for?

E-Mentoring

Face to Face Mentoring

Combination

SMART Mentoring
     
  Name:  
     
  Company or organisation:  
     
  Date of Birth:  
     
  Gender:  

Male Female
       
  Job title:  
     
  Work Address:  
     
  Work Postcode:  
     
  Work Telephone:  
     
  Work Fax:  
     
  Home Address:  
     
  Home Postcode:  
     
  Home Telephone:  
     
  Home Fax:  
     
  Preferred Email Address:  
     
  Brief Education History:  
     
  Brief Employment History:  
     
  Community Activities:
Please list current and past participation in community activities, including working with young people, e.g mentoring		  
     
  Leisure Interests:
Please list your leisure interests e.g. sports, hobbies, favourite music, movies, TV, shows, restaurants, holiday places		  
     
  Why you are interested in becoming a mentor:
Please explain briefly why you are interested in becoming a mentor and how you hope to benefit		  
     
  Do you have children of your own?   Yes No   Ages:
     
  Please indicate if you have experience of any of the vocatioal areas listed below:  
Accounting/Finance
Admin/Secretarial
Advertising
Arts
Automotive
Banking
Catering/Hospitality
Charity
Child Care
Construction
Creative/Design
Education/Training
Electronics
Engineering
Environmental
Executive/Management
Fashion
Financial Services
Government/Public Sector
Healthcare
Human Resources
IT
Insurance
Journalism
Legal
Marketing
Media/PR
Multilingual
Pharmaceutical
Printing/Publishing
Property
Purchasing
Retail
Sales
Science
Social Care
Sport/Recreation/Leisure
Telecommunications
Travel/Tourism
Research/Development
Production
Music
Performing Arts
Self employed
Able to advise on:
Time Management
Study Skills
CV advice
Languages
Interview Skills
Applying for jobs
Managing your finances
UCAS advice
University life
College advice
Grammar
Revision Tips
Work experience
     
  Any other information:
Please note any other information you feel is relevant to your profile (e.g. religion, languages spoken) that would assist the matching process, including qualities you have to offer a student		  
     
  Additional Opportunities
If you are interested in offering additional opportunities to your student, please check the relevant box. Your local delivery manager will be in touch with more information.
Work Place Visits
Work Experience
Mock Interviews
Masterclass/Visiting Lecturer
'Ask an Expert'
Primary Programmes
     
  Do you have a prefernce as to which borough you would like to volunteer in?
(NB We will do our best to honour this but can't guarantee your choice will be possible)
Camden
Islington
Kensington & Chelsea
Lambeth
Southwark
Wandsworth
Westminster
Any
     
 

Ethnic Group:
The ethnic / cultural / heritage information will be used for analysis and monitoring purposes only
Mixed (White & Black African)
Mixed (White & Black Caribbean)
Mixed (Any other mixed backgtound)
Mixed White & Asian
Asian or Asian British - Indian
Asian or Asian British - Pakastani
Asian or Asian British - Bangladeshi
Asian or Asian British - Other
Black or Black British - Caribbean
Black or Black British - African
Black or Black British - Other
Chinese
White (British)
White (Irish)
White (Other)
Any Other
Not Known / Not Given
     
  Do you consider yourself to have a disability?   Yes No
     
 

References:
As mentoring involves working with young people in the 14-19 age range certain measures have to be taken to ensure the safety of participating students. This involves a CRB (Criminal Records Bureau) police check and the taking of references. Your local delivery partner will contact you to arrange a CRB form, in the meantime could you please provide the names and postal addresses of two referees who are not related to you

First referee:

Second referee:
     
  Thank you for your interest in mentoring and your time completing this form. We will contact you soon.
     
   
     

PRIVACY STATEMENT