Governance Mentoring Programme 2023 - Gisborne Tairāwhiti: MENTOR Registration

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Complete this form to apply to be a mentor with the Gisborne Tairāwhiti Governance Mentoring Programme for 2023.

Programme commences with orientation in April 2023 and involves six mentoring sessions between April and November 2023.

This is a Community Governance Aotearoa initiative, delivered by Gisborne Volunteer Centre, in partnership with The Mentoring Foundation of NZ.

Email *

Tell us a bit about you

My given name (first name) is: *

My surname (last name) is: *

My phone number is: *

I currently work/volunteer at: *

My role is: *

I am: *

Female

Male

Gender diverse

Prefer not to say

Other:

My location is: *

Gisborne

Hicks Bay

Manutuke

Matawai/Motu

Muriwai

Ormond

Patutahi

Ruatoria

Te Araroa

Te Karaka

Tikitiki

Tokomaru Bay

Tolaga

Other:

My age is:

under 20

20-29

30-39

40-49

50-59

60-69

70+

Prefer not to say

Clear selection

My ethnicity is:

(please select all that apply)

African

Asian (other)

Australian

British

Central American

Chinese

European

Indian

Japanese

Korean

Māori

Middle Eastern

North American

NZ European/Pākehā

Pasifika

Pakistani

Russian

South African

South American

Sri Lankan

Prefer not to say

Other:

Required

My labour status is:

Full-time employed

Part-time employed

Not in paid employment by choice

Seeking employment

Retired

Student

Self-employed

Other:

Clear selection

My experience in the Governance Community Sector is: *

Less than 5 years

6-10 years

11-15 years

16-20 years

21-30 years

More than 30 years

Other:

My LinkedIn profile (if applicable) can be found at:

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