The Mentor Club Program Registration Form

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Program structure:

Commitment in the program involves:
● 3x 2hr group training sessions (Jan-Feb 2021)
● 5x 2hr group training and mentoring session per month (March 2021 - July 2021)
● 2x 2.5hr mentor/mentee training and group networking days (March 2021 and June 2021)
● Training manual, templates and resources supplied
● All training sessions will be recorded and uploaded online enabling you to view and listen them on the go as many times as you want
● Access to a online group for ongoing support and community in between training sessions as well as; coaching, mentoring and support from the program leader in between training sessions
● 1:1 career and leadership coaching and mentoring

The program will run from the 28th of January 2021 to the 28th of July 2021 and will take place via Zoom.

The program will take place on a Thursday and we will be in contact with you to confirm the program dates and times and will send you all relevant information and resources to get started.

Here are the dates for your information:

Thursdays 6-8pm:

- 28 January 2021 (Training day 1 and 2)
- 4,11 February 2021 (Training day 3)
- 9 March 2021 (mentor/mentee training and group networking evening, 6-8.30pm)
- 11 March 2021 (group training and mentoring session 1)
- 1 April 2021 (group training and mentoring session 2)
- 13 May 2021 (group training and mentoring session 3)
- 22 June 2021 (mentor/mentee training and group networking evening, 6-8.30pm)
- 24 June 2021 (group training and mentoring session 4)
- 22 July 2021 (Graduation + group training and mentoring session 5)

Got a question?

Call: 03 9249 4195
Email: Westvale@brimbank.vic.gov.au

Dates: Are you available for all or some of the group training dates above? Please note that these take place on Thursdays 6-8pm via Zoom. *

Yes I am available for all the dates above

No I am not available for any of the dates above but would still like to attend the program

I am available for some of the dates above

I am not available on Thursdays and or 6-8pm but would still like to attend the program

Required

Your full name: *

Email Address: *

Mobile Number: *

Postcode: *

Age:

Do you have any accessibility needs? If so, how can we best support you and what do you need?

What do you need help with right now? *

What are you struggling with the most? *

What do you most want to achieve from this program? *

What is your number one goal for your career/life right now?

Click agree to Media, liability and privacy release (data confidentiality clause) etc *

Yes

Required

Thank you: we will be in contact with you over the phone to confirm training dates/times and to complete the registration process.

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