Ground Forum Undergraduate Mentoring Programme 2022/23 Mentee Application Form
This form has been created to get a bit more information about you, the mentee, as so a suitable match with a mentor for the academic year can be made.  Please answer all the questions.

Data Protection Act
In accordance with the Data Protection Act, we have to ask you to sign the following declaration. You can be quite sure that all the information we collect will be used only for the purposes of the mentoring programme and kept confidential to the programme team: it will not be released to anybody else.
Email *
Consent Declaration: I agree that the information I provide, and the data collected from me during the programme, may be held and processed by The Ground Forum for the purposes of the mentoring programme. I agree to my application form (with the demographic data removed) being shared with my Mentor for the purposes of understanding more about my aspirations and expectations from the programme. I agree to my application form (with the demographic data removed) being shared with my university, if requested by them, for general reporting purposes. I agree that my demographic data will only be used anonymously for reporting purposes. *
Name *
Your phone number *
Your university and campus *
What is the course title that you are doing including award i.e. BEng, BSc, MEng Civil Engineering, Geology etc. *
Your current year of study *
How important are the following factors when we look at matching you with a mentor? *
Not important
Medium Importance
Very important
Field of Study
Geographical Location
Other (Specify below)
Other factor when matching mentor
Please include details here about modules that you have enjoyed or aspects of your course that have interested you *
Please give some details of your aspirations.  For example, what subject area or discipline you would like to start your career in?  Where you would like to be in the next five years?  Any career objectives you have that you would like to share *
Please include here a brief (500 word) statement that sums up why you think a mentor will help you, why you should be selected for the programme and what you would like to achieve from it *
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This form was created inside of STEER Support & Mentoring CIC.