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* 1. Name

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

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* 3. How did you hear about this program?

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* 4. Phone - Mobile

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* 5. Phone - Business hours

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* 6. Email address

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* 7. Current Position Title

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* 8. Current Company/Organisation

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

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* 10. State

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* 11. Years of overall legal experience

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* 12. Years of in-house experience

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* 13. Other employment experience outside of law

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* 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)

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* 15. In what industries do you have experience?

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* 16. In which areas of specialisation do you have experience?

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* 17. In which of these professional development areas are you best equipped and motivated to assist a mentee?

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

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

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

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* 21. What past mentoring experience do you have?

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

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* 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

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

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.

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