*For organizations: referral form for potential candidates to participate as mentees in the professional mentorship program run by Kimiyaa in London.

**For individuals (mentee candidates): if you are an individual filling out the form, please skip to Section 2.

Privacy: Kimiyaa will record and store personal information about the candidate in order to make the best decision as to the candidate's fit for a mentorship program. Each candidate has the right to change, restrict and erase the information on this form. Kimiyaa will not share this information with anyone without seeking permission.