Linked-In Mentoring Program Application Form Use this form to register to be a Mentor in our Linked-in Mentoring Program.Section A Full name:* - required Date of birth: Address:* - required Email:* - required Phone:* - required Section B Why do you want to become a mentor?:* - required What do you hope to get out of being part of the program?:* - required Section C Are you currently employed?:* - required [Please Select] Yes No Name of employer: Are you currently studying?:* - required [Please Select] Yes No Name of employer: List of previous employers (up to 3 years if applicable):* - required Would you be available for interviews during business hours?:* - required [Please Select] Yes No Section D Do you have any health issues that may affect your role in the program:* - required [Please Select] Yes No If yes, please specify: Section E Do you hold a current NSW Working with Children Check clearance?:* - required [Please Select] Yes No If yes, please provide Working with Children Check number: Section F Do you sincerely feel that you can make a minimum commitment of one Tuesday, a week from 1pm - 3pm for 9 months to the program?:* - required [Please Select] Yes No Do you agree to conduct yourself under the guidance and supervision of the Council/School employee responsible in the Linked-In Mentoring Program?:* - required [Please Select] Yes No How did you hear about the program?* - required Do you agree to participate in training?:* - required [Please Select] Yes No Section GPlease provide details of your referees.Referee 1 Name:* - required Address:* - required Email:* - required Phone:* - required Relationship to you:* - required Referee 2 Name:* - required Relationship to you:* - required Phone:* - required Email:* - required Address:* - required Section HPlease tick each box to agree to the program's terms and conditions. I agree all the information I have provided above is correct to the best of my knowledge.* - required I agree to referees being contacted in relation to this application to provide voluntary services to Council.* - required I agree to conduct myself under the guidance and supervision of Council/school employee responsible for the Linked-In Mentoring Program.* - required I agree to contact the Council employee designated to the Linked-In Mentoring Program if I intend to vary the nature of my involvement in the Linked-In Program.* - required I understand that Council may terminate my volunteering services if I do not comply with any aspect of this agreement.* - required I agree to inform Council of any injuries sustained whilst undertaking volunteering activities.* - required I understand that all claims for any medical costs incurred as a result of my volunteering activities will be made upon my own medical fund.* - required I am willing to undertake any training deemed necessary by Council in relation to my volunteering services to ensure that I comply with all policies, legislative obligations of Council and standards of conduct.* - required I understand that as a volunteer I am expected to maintain the same standards of confidentiality, courtesy and organisational discipline as Council's paid employees.* - required I agree to conduct myself in a constructive and cooperative way with Council staff and with other volunteers and to comply with any safety procedures requested.* - required I understand that I am volunteering my services to Council and will not receive remuneration for my Services (including transport to and from venues).* - required I will inform Council when I no longer wish to be involved in for volunteering activities for the Linked-In Mentoring Program and when I am unable to attend the scheduled volunteering activities.* - required Single Checkbox* - required Mandatory field(s) marked with *
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