Mentorship Application - Corporate Career Academy

Name *

First

Last

Phone

Email *

Job Title *

Professional Designation: *

Employment

Self Employed
Employed

Company:

Employer:

Are you prepared (and have capacity) to commit a minimum of one hour per month to this 3 month programme (per mentee)? *

Yes
No

Please select the reason(s) for wanting to be a mentor: *

Personal and career development
Leadership and/or skills development
Building and maintaining professional networks
Develop a community of learning within SARA
Reinforce learning and development by sharing knowledge and skills

Please add any other reason(s) not listed above.

Please list your areas of expertise, knowledge and/or experience that you can mentor on: *

Interpersonal and/or Business skills *

Other (please specify):

Please tell us a bit more about yourself to help us pair you with an appropriate mentee(s). *

How many mentees would you be willing to mentor during the 8-month programme? (time commitment is expected to be a minimum of one hour per mentee per month)

1
2
3
4

General comments that you feel are important for us to know *

Have you mentored a mentee before – formally or informally?

Yes (formally)
Yes (informally)
No

Applicant declaration

I acknowledge that any personal information supplied to CCA is done so voluntarily to facilitate the processing of this application. I furthermore acknowledge that the information provided by me, is to the best of my knowledge both true and correct, and I understand that any incorrect or inaccurate information or documentation submitted may adversely affect the manner in which CCA processes my application to be a mentor.

Disclaimer

The information you are voluntarily providing will be used to help assist us in achieving our mentorship programme goals for CCA.

The information collected will only be shared with the CCA Mentorship Committee with your consent below.

Consent

Please tick the box below to accept the declaration and disclaimer above.