EXPRESSION OF INTEREST

Mentee Application form

Name(Required)

Where in the Mid-Western region are you located?(Required)

What is your website / professional FB / LinkedIn profile?

What is your best contact number?(Required)

What is your email address?(Required)

What is your current line of business / job role?(Required)

How many years has your business been operational / how long have you been in this role?(Required)

What are your greatest strengths?(Required)

What key areas would you like to develop in?(Required)

What's the #1 thing you want to get out of a Mentoring program?(Required)

Describe your 5-year business vision / career vision(Required)

What are some specific challenges you are experiencing and trying to overcome at the moment?(Required)

Describe your ideal mentor(Required)

Thank you for expressing your interest in the Mid-Western Mentoring Program, we will be in contact with you to further discuss your application. Successful applicants will be required to make payment to Mid-Western Mentoring Ltd prior to their place on the program being confirmed. If you have any questions please contact pearl@mwmentoring.com.au

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