Mentee Survey

Please complete the following details to submit your interest as a Mentee in our Emerging Leaders Mentoring Program.
Contact Phone Number:
Area of residence (city/state):
Gender:  Female
Date of Birth:
Desired Area of Expertise in T&L of Mentor:
In what areas do you seek development?:
What expectations do you have for this Mentor Program?:
Academic Interests / Career Interests:
Please list your Hobbies:
Additional Comments:

Commitment Agreement:

I am committed to open and honest communication in my mentoring relationship. I will discuss and attempt to resolve any conflicts with my mentee as they arise. I will ensure that any issues discussed are held in confidence. I will contact the program officer with any questions, concerns, or suggestions that may arise. I acknowledge that this information will be shared with my Mentor.

I agree:  Yes

Sectional Partners

Email:  | Phone: 1300 68 11 34 | Address: PO Box 3161, Caroline Springs, Vic 3023 | ABN 47 367 894 930 All rights reserved.


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