Fields marked * are required
First name *
Last name *
Email *
Mobile *
Age * Select Less than 24 years old 25-34 years old 35-44 years old 45-54 years old 55+ years old
Organisation*
Job title *
Index *
Industry sector *
Career summary, referencing roles and sectors worked in *
Please give details of your last three roles
Specific career experience (e.g. M&A activity, Activist investors, ESG, etc.) *
Have you previously been a coach or mentor? * Select No Yes
If you have previous experience as a mentor or coach, and feel additional information about this would be helpful, please give details below (not essential)
Why do you think you would make a good mentor? *
Which areas do you feel you would most like to mentor someone in? *
e.g. M&A activity, Activist investors, ESG, etc., including if relevant, industry-specific expertise
Mentees may be either IROs or advisors – if you have a preference please indicate below. I would like my mentee to be: * Select An IRO A service provider/advisor No preference
We would hope that with six meetings anticipated over six months, mentors and mentees would be reasonably flexible about meeting times. However if there are times (for example weekdays evenings, weekends) when you are absolutely not available, then please note this here
If it isn’t possible to match you on this occasion, we would love to be able to keep your information on file for future schemes. Please let us know if you are happy for us to do so. * Select Yes, please keep my information on file for future schemes No
Please tick the boxes to confirm
I have read and understood the mentoring charter *
I consent to my information being used in the way described in the mentoring charter *
I will not divulge any information about individuals or their contact details obtained through the mentoring scheme to any third party *
Please check that you have completed all the required fields.