2022 Future Leaders Mentoring Program - Mentee 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 a in-house legal role

I understand the program runs from 1 February to 30 November 2022

I am committed to attending the opening and closing events in my state or the opening webinar

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

Comment (if required):

3.I understand that if a suitable mentor is confirmed for me a non-refundable administrative fee will apply (tick the option that applies to you)

I applied on or before 12 November, so a fee of $195 (plus GST) will be invoiced

I am eligible for the two-for-one special offer

I applied after 12 November, so a fee of $395 (plus GST) will be invoiced

I have applied as a mentor and mentee and if a suitable mentee match is found no fee shall apply, as I applied on or before 12 November, it will be $195 (plus GST) if no suitable mentee is found

I have applied as a mentor and mentee and if a suitable mentee match is found no fee shall apply, as I applied after 12 November, it will be $395 (plus GST) if no suitable mentee is found

Other (Please specify)

4.How did you hear about this program?

Other (please specify)

5.Phone - Mobile(Required.)

6.Phone - Business hours

7.Email address(Required.)

8.Current Position Title(Required.)

9.Current Company/Organisation(Required.)

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

12.Years of overall legal experience(Required.)

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

14.Other employment experience outside of law

15.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)

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

20.How important is geographical location to your mentor choice?

Very important, I would only want to be matched with a mentor 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

21.What importance does industry background have in your mentor selection?

Not at all important

I'd prefer a mentor from a similar industry

I'd prefer a mentor from a different industry

Other (please specify)

22.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

23.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 be processing the applications after the close-off date (3 December 2021). You can expect to hear from Karina by mid-January.

Please note, to ensure a positive experience for both mentees and mentors, we will only match you with a mentor who is believed to be a strong fit. If a suitable match is not found for you, Karina will notify you by the end of January and you will have the option to be placed on the waiting list for the next program.

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