User Login
Register Lost Password

Mentor Form

This application is designed to outline your goals and expectations as a Mentor. Please type your answers directly into the box provided and take the time to give us as much relevant information as you can. The information you provide is confidential and is intended to assist with the mentor/mentee matching process.
 
Please note that all mentors participating in the program must attend the three compulsory workshops and set aside one hour per week to meet with their mentee.
Section 1
First name: *
Surname: *
Address: *
Address:
Suburb: *
Postcode: *
State:
Phone: *
Fax:
Email: *
Position: *
Age Range:
Under 25   25 - 35   35 - 45   Over 45  
Industry Experience:
Section 2

This section is to let us know what you have to contribute as a mentor to our program. Obviously your career achievements are important, but you may also want to include other areas, such as personal and social activities and interests. It could be a particular turning point or strategies that have been helpful throughout your life or career. The following sub-headings are a guide, but please feel free to modify these if necessary.
Career – positions held throughout your working life:
Personal – interests & activities; personal strengths:
Social/Community – organisations and involvement:
Important turning points or strategies that have been helpful to you:
List 3 things that you have come to value most over the course of your career:
Section 3
Have you previously taken part in a mentoring program? Yes  No
Was the program?
Please comment on your experience:
What do you hope to gain from the mentoring program?
What do you see the mentee gaining from the program?
Any other comments:
Section 4

Please read the mentoring code of practice and sign the declaration.

Mentoring Code of Practice

The mentor’s role is to respond to the mentee’s needs and agenda; not to impose their own agenda on the process.

Mentors and mentees should respect the confidential nature, including business and personal information, of what is discussed as part of the mentoring relationship.

Mentors and mentees should respect each other’s time and other responsibilities and commitments, ensuring they do not impose beyond what is reasonable.

The mentee must accept increasing responsibility for managing the relationship. The mentor should empower them to do so and must generally promote the learner’s autonomy.

Either party may dissolve the relationship. Notice to do so must be made in writing to the NIBA Mentoring Committee. However, both the mentor and mentee have the responsibility to discuss the matter together as part of their mutual learning. They need to realise that this action should be a last step as they have made a commitment to complete the program in good faith.

Mentors need to be aware of the limits of their own competence in the practice of mentoring.

The mentor will not intrude on areas the mentee wishes to keep private until invited to do so. However, they should help the mentee to recognise how other issues may relate to these areas.

Mentors and mentees should aim to be open and truthful with each other and themselves about the relationship itself.

Mentors and mentees share the responsibility for the smooth winding down of the relationship when it has achieved its purpose – they must avoid creating dependency.

The mentoring relationship must not be exploitive in any way, neither may it be open to misinterpretation.

Mentors and mentees must abide by the commitment that the mentoring program is not to be used as an employment/recruitment possibility.

Mentors and mentees agree to attend all structured training sessions in the program.

Declaration
I have read and agree to abide by all the conditions of the Mentoring Code of Practice? Yes  No
Date: 19/5/2012 
* Indicates a mandatory field.