World Heart Beat Mentee Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Name *

Age *

Contact (phone and email address) *

Emergency contact details (name and phone number) *

What are you hoping to gain from working with a mentor? (Please tell us at least three things)

What skills would you like to develop? *

Do you have any particular career goals or is there an industry you are interested in working in?

Demographics data

We collect this data for our funder. Please only answer what you feel comfortable with.

How would you describe your gender?

(e.g. male, female, non-binary)

How would you describe your ethnic origin?

Which borough do you live in?

Are you currently working or studying?

Are you eligible for free school meals or were you when you were at school?

Baseline questions

CREATIVITY

On a scale of 1-5, how do you agree or disagree with the following statements?(1- Strongly Disagree; 2- Disagree; 3- Neutral; 4- Agree; 5- Strongly Agree) 

I can produce a great number of ideas. *

I feel motivated to be creative in an environment that I know will be supportive/encouraging. 
*

I feel free to do my own thing musically. 
*

I am able to persuade others that my ideas are valuable. *

I do not feel constrained by conventional ways of doing things. *

PERSONAL RESPONSIBILITY

On a scale of 1-4, I believe that…(1- Strongly Disagree; 2- Disagree; 3- Agree; 4- Strongly Agree)

I am responsible for the choices I make.
*

I choose how to respond in situations. 
*

I have expectations for myself and my own behaviour.
*

If you work hard you will succeed. 
*

How well I treat others plays a part in how well we get on
*

SELF-CONFIDENCE

On a scale of 1-5, how often do you feel the following...(1- None of the time; 2- Rarely; 3- Some of the time; 4- Often; 5- All of the time) 

I feel optimistic about the future. 
*

I feel good about myself. 
*

I feel close to other people. 
*

I feel confident. *

I feel cheerful. *

SELF-ESTEEM

On a scale of 1-5, how much do you agree or disagree with the following statements? (1- Strongly Disagree; 2- Disagree; 3- Neutral; 4- Agree; 5- Strongly Agree) 

I feel I have a lot to be proud of. *

I feel I am a person of worth and equal to others. *

I can always manage to solve difficult problems if I try hard enough. *

It is easy for me to stick to my aims and accomplish my goals. *

Setbacks don't discourage me. *

MUSICAL ABILITY

On a scale of 1-5, studying at World Heart Beat how confident do you feel…(1- Not strongly confident; 2- Not confident; 3- Neutral; 4- Fairly confident; 5- Very confident) 

Playing an instrument/singing. *

Reading music. *

Playing with feeling. *

Playing as part of a group. *

Creating a strong relationship between music and my life. *

MOTIVATION

On a scale of 1-5, I believe that...(1- Strongly Disagree; 2- Disagree; 3- Neutral; 4- Agree; 5- Strongly Agree) 

If I study hard, I will achieve more. *

If you work hard, you will get what you want out of life. *

I am responsible for what happens to me. *

Studying music has improved the way I study at school. *

COMMUNICATION SKILLS

On a scale of 1-5, how much do you agree with the following statements? (1- Not at all; 2- Rarely; 3- Sometimes; 4- Often; 5- Very often) 

If I don't understand something, I tend to ask others for help. 
*

I'm surprised if people don't understand me. 
*

When people talk to me, I try to see their perspectives.
*

Before I communicate, I think about how best to convey my point. 
*

I have improved my communication skills. *

EMPLOYABILITY

On a scale of 1-5, I feel confident that… (1- Strongly Disagree; 2- Disagree; 3- Neutral; 4- Agree; 5- Strongly Agree) 

I can find an occupation which interests me. 
*

I can find an occupation which makes a contribution to society. 
*

I will be able to achieve what I want to. 
*

That I will be able to find a job in a field that interests me. 

I will be successful. *

I have the right experience to find work. 
*

I have relationships that will help me get a job.
*

I have an understanding of a range of roles in the music and creatives industries.
*

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of World Heart Beat Music Academy. Report Abuse

Forms