ACC Australia Future Leaders Mentoring Program Mentor Application Form Survey

1.Name(Required.)

2.Program Commitment: In applying for participation in the Association of Corporate Counsel (ACC) Australia Mentoring Program, I confirm that:(Required.)

I am a fully paid member of ACC Australia

I am currently employed in an in-house legal role

I understand the program runs for ten months

I am committed to meeting (either in person or in a virtual capacity) with my mentee monthly

Comment (if required):

3.How did you hear about this program?

Other (please specify)

4.Phone - Mobile(Required.)

5.Phone - Business hours

6.Email address(Required.)

7.Current Position Title(Required.)

8.Current Company/Organisation(Required.)

9.Geographical location (town, city or suburb)(Required.)

11.Years of overall legal experience(Required.)

12.Years of in-house experience(Required.)

13.Other employment experience outside of law

14.Please paste the link to your LinkedIn or other online bio here (if you do not have an online profile, please email your CV to mentoring@accglobal.com)

18.How important is geographical location to your mentee choice?

Very important, I would only want to be matched with a mentee who could meet me in person close to my work or home

I'd prefer being able to meet face-to-face, however, if the best match for me is in another state, I would be open to a virtual relationship

Not important, having the closest possible match is more important to me than location

19.What importance does industry background have in your mentee selection?

Not at all important

I'd prefer a mentee from a similar industry

I'd prefer a mentee from a different industry

Other (please specify)

20.What motivates you to be part of this mentoring program?

21.What past mentoring experience do you have?

22.Please comment on your mentoring style and what you might be able to provide a mentee.

23.Please add any other information that may help us make the best possible match and/or note any special requests you have regarding how you are matched

24.Do you require a conversation with the program facilitator prior to match selection?

Yes

No

Other (please specify)

Thank you for taking the time to complete this application.

The Program Facilitator, Karina Butera, will enter your details into the mentor register and will be in touch as soon as a suitable mentee is selected.

Please note, to ensure a positive experience for both mentees and mentors, we will only match you with a mentee who is believed to be a strong fit. If a suitable match is not found for you, Karina will notify you once all matches have been confirmed, and you will have the option to be placed into the mentor pool for the next program.

If you have any questions or concerns, please contact Karina directly at Mentoring@accglobal.com or on 0413 041458.