2019 WIMBIZ MENTOR DATA FORM
Thank for your interest in attending the 2019 WIMBIZ Mentoring Program, To register, Kindly fill in your details in the form below or tick the necessary information.
Title *
First Name *
Your answer
Last Name *
Your answer
Age *
Phone Number *
Your answer
Email Address *
Your answer
Contact Address *
Your answer
Civil Status *
Highest Education Qualification *
State of Residence *
Name of Organisation *
Your answer
Present Job Title *
Your answer
Sector *
If Others, kindly state here
Your answer
Are you a WIMBIZ Associate? *
How long have you been in paid employment/ business? *
What is your life goal (SMART Goal)? *
Your answer
What have you done in the past two years to develop yourself in line with your career goals? *
Your answer
Why do you want to be a mentor? *
Your answer
Have you ever had a mentoring relationship? *
How long did it last?
Was it beneficial?
List three attributes you would like in a mentee? *
Your answer
Kindly state any special knowledge or skill that you possess? *
Your answer
Will you be willing to commit to a 1 day Mentor’s brief? *
Will you be willing to commit to an 8-month mentoring relationship? *
Are you willing to communicate electronically or physically with your mentee at least once a month? *
What are your two (2) most preferred means of communication? *
Required
Comments (kindly supply any other information that you think might be important in the selection process) *
Your answer
Please provide your short profile (not more than 200 words) *
Your answer
Additional Information
Please send your passport photograph and CV to mentoring@wimbiz.org using the subject title "Mentor - Your fullname" on or before Monday, January 14, 2019
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