Foróige's Third Level Mentoring Programme with University of Galway: Mentor Application Form

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Foróige works in collaboration with University of Galway to facilitate the mentoring programme, when you complete the below form the information goes directly to Foróige. University of Galway and Foróige respects your right to privacy and complies with our obligations under the Data Protection Acts 1988, 2003 and 2018. The information provided on this form will be used for the purposes of assessing your application to be part of Foróige’s Third Level Mentoring Programme in University of Galway. Foróige & University of Galway will act as joint data controllers in respect of the personal data provided, which means it will be responsible for how this personal data is processed. University of Galway and Foróige will not process your data for any other purpose other than assessing your application for the Foróige’s Third Level Mentoring Programme. We will not disclose your personal data to third parties unless we believe, in good faith, that we are required to disclose it to comply with any applicable law or statutory requirement.

My Details

First Name *

Surname *

University of Galway Email *

Mobile Number *

Gender (This information in needed for matching purposes). *

Female

Male

Non Binary

Age (This information in needed for matching purposes). *

18-22

23-34

35-44

45-54

55-64

65 or over

Why do you want to volunteer with Foróige’s Third Level Mentoring programme with the University of Galway? *

Your Skills and Experience

Please list skills / hobbies you have *

Department/Functional Area in University of Galway *

University of Galway Office/Number Location *

Have you received Garda Vetting through University of Galway? *

Yes

Have you had previous youth work experience? *

Yes

If yes, what, where and how long for?

Reference

Please give details for one person(non- relative), who knows you well i.e. in regular contact over a sustained period of time 1-2 years, and can provide us with a reference. This referee will be contacted by phone/email to provide a reference for you. Please inform them of this.

Please provide: Name, mobile no, email and how you know the referee *

Celebrating Our Diversity

Please help us measure how we are welcoming volunteers from diverse backgrounds in our society by ticking which of the following applies to you(as used in Census 2016):

White Irish

Irish Traveller

Any other White background

Black

Black Irish

African

Any other Black background

Asian

Irish Asian

Any other Asian background

Mixed background

Prefer not to say

Other:

Do you have a disability which may impact on your role? *

Yes

If so, is there anything you would like us to do that would support your ability to volunteer with us?

GENERAL DECLARATION - Please Read Carefully

I confirm that nothing within my personal or professional background makes me unsuitable for working with students in University of Galway.
I declare that all the information I have put on this form is true.
I understand that volunteers cannot work with mentees until all elements of the selection process, including are successfully completed.
I accept that Foróige and University of Galway reserves the right to accept or decline applications without giving reasons; and that information supplied on this form will not be used to unfairly exclude any applicant.

Have you read the above statement and agree? *

Yes

Thank you for applying to be a mentor in the Foróige Third Level Mentoring Programme with the University of Galway. A staff person will be in contact in due course.

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