GEN UK Approved Mentor Scheme Application Form

Please fill in your details below

Name

Email (required)

Phone

Company Name

Job Title

Location (City, Town)

Short Description of your role – key functions and responsibilities (required)

Summarise your experience of mentoring, coaching or developing others (in work or non-work related situations) (required)

Do you have experience of starting your own venture? Please provide details of your roles, experiences and sectors. (required)

What skills, knowledge and interests do you have which might support the development of a startup? (Please think of subject/technical skills as well as human ‘process’ skills of listening, support etc.) (required)

Which sectors or types of business that you would prefer to mentor? (required)

Why do you want to be part of the GEN UK Approved Mentor community? (required)

What do you want to learn/take away from the experience of being a mentor? (required)

If you have mentored already, please give the contact details of 2 people you have mentored and describe how you worked with them and the goals they achieved.

Have you been involved with bankruptcy proceedings or been struck off as a company director?

Yes

Please provide at least one reference of an employer or client (required)

If you have professional indemnity insurance please give details.