Wisdom Mentoring Programme

Transcription

1 Wisdom Mentoring Programme Programme Application Application Form The application for the Wisdom Mentoring Programme consists of the Personal Information, Statement of Interest, and Mentoring Programme Mentee Profile. In addition, please include a copy of your CV when returning the completed application package. Declaration: I hereby declare that all of information provided in the 2018 Wisdom Mentoring Programme application is complete and true in every respect, and that I have answered all questions applicable to me in this application. Executed at Signature: (CITY, DAY, MONTH, YEAR), this day of, 20 (For electronic application, please include your initials only) 1 P a g e

2 II. Personal Information Name in full: FAMILY NAME FIRST, MIDDLE AND OTHER NAMES Please indicate your age group: < 27 years years years years years years years 55 + Asked for the purposes of ensuring the best mentor-protégée match Years of professional full-time work experience YEARS Years of leadership experience (mentees must have upwards of 10 years ) YEARS Mailing address: NUMBER AND STREET CITYTOWN POSTAL CODE BUSINESS TELEPHONE ALTERNATE TELEPHONE NUMBER (home or mobile please indicate) 2 P a g e

3 Educational History: Post-secondary or university level (List planned or most recent studies first) 1. NAME OF INSTITUTION CITYTOWN PROVINCESTATE COUNTRY START DATE (MMYYYY) GRADUATION DATE (MMYYYY) FIELD OF STUDY SPECIFY DEGREE OR CERTIFICATE RECEIVED OR EXPECTED 2. NAME OF INSTITUTION CITYTOWN PROVINCESTATE COUNTRY START DATE (MMYYYY) FIELD OF STUDY GRADUATION DATE (MMYYYY) SPECIFY DEGREE OR CERTIFICATE RECEIVED OR EXPECTED Employment History List current or most recent first 1. EMPLOYER TITLE DATES WORKED FROM (MMYYYY) TO (MMYYYY) 3 P a g e

4 2. EMPLOYER TITLE DATES WORKED FROM (MMYYYY) TO (MMYYYY) 3. EMPLOYER TITLE DATES WORKED FROM (MMYYYY) TO (MMYYYY) List of Significant Accomplishments (Academic andor professional) List of Leadership and Volunteer Experience Provide examples of your leadership accomplishments andor volunteer experience Leadershipvolunteer accomplishment Duration (yyyy yyyy) 4 P a g e

5 List of Awards or Scholarships List the most recent awardsscholarships first AwardScholarship Date received (mmyyyy) How did you hear about this programme? 5 P a g e

6 III. Statement of Interest Please answer the following questions: o Why are you pursuing this mentorship programme? o How would the mentoring programme contribute to your professional development? o What are your future goals? *The statement must be no longer than 500 words. 6 P a g e

7 Wisdom Mentoring Programme Mentee Profile In order to assist your mentor and to provide an introduction of your skills, experience, goals and objectives, we request that the following Mentee Profile be completed and returned as the final portion of your application. The Mentee Profile information will be directed to your mentor in preparation for your mentoring sessions once you are successfully placed in the programme. Name: Professional Title: Place of Work: Business Telephone: Please provide a brief (max 100 words) personal biography: 7 P a g e

8 Why do you believe that you will benefit from this programme? What outcomes are you anticipating from this programme? What are 3 obstacles that are of concern to you that you would like to discuss during the programme and with your mentor (professional or personal)? Thank you for your application. Submit Application All fields must be complete in order to submit your application. If you encounter issues submitting this application, please save a completed copy and send it to wisdom@wxnetwork.com. 8 P a g e