WiHTL Reverse Mentoring Programme for Ethnic Minority Employees - Mentee Form June 2020
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Email *
Mentee first name *
Mentee last name *
Mentee Contact Email Address *
Mentee Contact Mobile Number *
Job Title *
Business / Organisation Name *
Work location *
Do you have a LinkedIn profile or a bio on your website? If yes, please share the link here. http://uk.linkedin.com/in *
Why do you want to take part in this programme?
In which areas do you have skills and knowledge to share? Please select the top five areas where you have significant expertise and experience that you could share with a mentor. *
Required
Which five topics would you feel comfortable focusing on in your mentoring relationship? While you might have experience in many of these areas, please only select the top five as this will help us match you with your mentor. *
Required
How would you describe a successful mentoring relationship? *
What do you hope to share with your mentor? Please tell us about your personal interests. *
What motivated you to want to be a mentee and what do you want to achieve from the list below by participating in the reverse mentoring scheme? *
Required
If Other, please state
Of the above, which are your ‘top three’ desired outcomes?  
Do you have any apprehensions regarding taking part in the reverse mentoring programme? If so, please share details.
How many mentors would you be willing to accept at one time? *
Is there anything else you'd like us to know? Any other preferences you'd like to share? Is there any additional support you would need from WiHTL to enable you to become an effective mentee in this reverse mentoring relationship?
Thank you for completing the Mentee Application Form
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We take your privacy seriously and we will only use your personal information to contact you in relation to WiHTL initiatives. Should you be unhappy with us retaining your personal information (name, title, name of company, email address) in our secure database, or should you want to change any of the data we hold, please contact info@wihtl.com and we will delete or amend our records accordingly.  
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