CJ Adult Mentoring - Mentor Registration Form (Spring Crash Course 2023)

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This is the registration form to become a mentor for The ClementJames Centre's Adult Mentoring Scheme.

This scheme aims to equip clients with the skills needed to prepare and deliver a presentation as well as help them improve their public speaking skills and confidence in communication.

It will consist of four three hour sessions running from 10am - 1pm on 18th, 19th, 20th and 21st April. This term, the programme will be held at the Baseline studios at W11 4AT, which is located across the road from our centre. On the second day of the programme we will be hosting a workshop in the St. Clement's Church with the public speaking training provider Dramatic Resources (https://www.dramaticresources.co.uk/). No experience in mentoring is required as ClementJames will provide training for all mentors, however it is expected that you will have some experience using public speaking in your job role to draw on when coaching your mentee.

There will be an online training session ahead of the start date which will be held via Zoom (the link for which will be emailed to you once you have completed this form). Furthermore, a member of staff will also be available at all times during the sessions to assist you if needed.

Give the nature of this programme, we ask that you commit to all three sessions.

Please fill out the below form if you are interested in participating!

Privacy Statement *

At The ClementJames Centre, we’re committed to protecting and respecting your privacy. In order to process your registration and to provide the best possible service to you we need to collect certain information about you and your circumstances. When you give us personal information, we take steps to ensure that it’s treated securely and confidential. We may need to share some of your information with our funders. This can be either in an anonymised or non-anonymised form. We need to do this for monitoring purposes of the grants they give us to run our services. You can view our full privacy policy on our website: https://clementjames.org/privacy/

*Please note, this programme is a partnership between Lancaster West Neighbourhood Team and the Clement James Centre. By signing this form, you give permission for your data and consent to be shared between partners, in line with GDPR guidelines.*

I have read the above and agree to the terms laid out in the privacy statement

Required

Photo Permission

I hereby give my permission for The ClementJames Centre to use my photograph in their promotional materials, including their social media accounts and resources they may use for funding purposes.

Yes

Required

Name *

Date of birth *

YYYY

Email address *

Phone number *

Current role

Have you had any experience with mentoring before?

Yes

Clear selection

What can you bring to the mentoring scheme?

Confirmation *

I commit to attending the four sessions as scheduled by the ClementJames Centre or to let the centre know in advance if I cannot make a session.

I understand this term's Mentoring Scheme will take place at the Baseline Business Studios and that sessions need to start on time and I will be punctual with attending

I agree to maintain confidentiality with my mentee throughout the sessions unless there is a safeguarding concern, which I will report accordingly to a staff member of ClementJames.

Required

Many thanks, we look forward to having you join us!

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