We Speak Mentor registration form - Autumn 2024
*
1.
First name
(Required.)
*
2.
Last name
(Required.)
*
3.
Email
(Required.)
*
4.
Company
(Required.)
*
5.
Job title
(Required.)
6.
Mentor training
- which dates are you available for? All sessions take place
2-4.30pm
(You'll only attend 1 session but please say Yes to as many options as possible as we'll choose the most popular dates)
Yes
No
If needs be
Mon 14 Oct 2-4.30pm
Yes
No
If needs be
Tue 15 Oct 2-4.30pm
Yes
No
If needs be
Wed 16 Oct 2-4.30pm
Yes
No
If needs be
Thur 17 Oct 2-4.30pm
Yes
No
If needs be
Fri 18 Oct 2-4.30pm
Yes
No
If needs be
Mon 21 Oct 2-4.30pm
Yes
No
If needs be
Tue 22 Oct 2-4.30pm
Yes
No
If needs be
Wed 23 Oct 2-4.30pm
Yes
No
If needs be
Thur 24 Oct 2-4.30pm
Yes
No
If needs be
Fri 25 Oct 2-4.30pm
Yes
No
If needs be
Mon 28 Oct 2-4.30pm
Yes
No
If needs be
Tue 29 Oct 2-4.30pm
Yes
No
If needs be
Wed 30 Oct 2-4.30pm
Yes
No
If needs be
Thurs 31 Oct 2-4.30pm
Yes
No
If needs be
Fri 1 Nov 2-4.30pm
Yes
No
If needs be
*
7.
Programme
- which dates are you available for? (You'll attend 1 hour a week over 4 weeks, on the same day/time each week. Please say Yes as many options as possible so we can find the best dates for everyone.)
(Required.)
Yes
No
If needs be
3.30-4.30pm on Mondays (4, 11, 18, 25 November)
Yes
No
If needs be
3.30-4.30pm on Tuesdays (5, 12, 19, 26 November)
Yes
No
If needs be
3.30-4.30pm on Wednesdays (6, 13, 20, 27 November)
Yes
No
If needs be
3.30-4.30pm on Thursdays (7, 14, 21, 28 November)
Yes
No
If needs be
3.30-4.30pm on Fridays (8, 15, 22, 29 November)
Yes
No
If needs be
Other (please specify)
8.
Please state any dates that you'd need to miss
9.
Would you prefer to take part as a mentor in Summer or Autumn?
Autumn - November 2024
Spring - March 2025
Summer - June 2025
Any is fine
10.
If you had the choice, would you prefer your sessions with the students to be 1 or 1.5 hours?
1 hour
1.5 hours
11.
Why would you like to take part in the programme?
*
12.
Rate your skills on scale of 1-10, where 1 is 'skill not developed' and 10 is 'skill completely developed'. (The We Speak mentor training will help you develop these skills so it's useful to know your assessment of this)
(Required.)
1
2
3
4
5
6
7
8
9
10
Active listening
1
2
3
4
5
6
7
8
9
10
Asking open questions
1
2
3
4
5
6
7
8
9
10
Giving supportive feedback
1
2
3
4
5
6
7
8
9
10
Helping others build their confidence
1
2
3
4
5
6
7
8
9
10
*
13.
Are you happy for We Speak to email you with updates including social impact of the work you're doing or any We Speak opportunities you may be interested in. We will process your data in accordance with our privacy policy (www.wespeak.co/privacy-policy). You can withdraw consent any time by emailing laura@wespeak.co, or clicking unsubscribe on communications
(Required.)
Yes
No
*
14.
Are you happy for us to use screenshots and videos for promotional purposes? (Tick as appropriate)
(Required.)
Yes
No
Yes, I am happy for you to use screenshots
Yes
No
Yes, I am happy for you to use videos
Yes
No
Yes, I am happy for you to use my name next to quotes
Yes
No
Yes, I am happy for you to use my name next to screenshots
Yes
No
This might include but is not limited to the right to use them in our printed and online publicity, social media and programme material. We will process your data in line with our privacy policy (www.wespeak.co/privacy-policy). You can withdraw your consent at any time by emailing laura@wespeak.co
By submitting this form you are agreeing that We Speak will contact you about the We Speak programme, that we can record sessions for safeguarding and evaluation purposes, that we can take quotations from feedback and sessions to be published anonymously to promote We Speak's work, and you agree that we will process your data in line with our privacy policy (www.wespeak.co/privacy-policy). We will keep information for a reasonable period.