PHONE: 03 5381 0122 | EMAIL: info@llen.com.au

MATES Mentor Application

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MATES Mentor Application Form
This is helpful when we are matching you to a mentee
If you are not employed, please go to the next question
Please list other areas of expertise or interest.
Please list previous work experiences or community involvement. Include name of organisation, positions held and period of involvement.
List any training or expereince you have had which may enhance your role as a mentor e.g. scout/guides leader, teacher's aide, sports coach...
Please provide contact details of two people you would like to use as character referees. Any information the MATES Mentoring Porgram gathers from these referees will be held as confidential and not released to you, the applicant. Please note: it will be the responsibility of the applicant to inform the referees listed that they will be participating in this personal reference check and will be contacted by the MATES Program Coordinator.
Please indcate the day/s that would be most convenient for you to meet with yur mentee.
See the list below if necessary.
The information you provide about yourself will be used to find a good match for you. We aim to match mentors and metees who have some similar interests.
Please indicate if you have a preference to mentor a student in a particular school or town.
It is mandatory for all MATES mentors to have a current Working With Children Check
I agree to allow the MATES Mentoring Program to use any photographic image, film or voice recording taken of me whilst participating in the mentoring program for promotional purposes. These images may be used by the School or the Wimmera Southern Mallee Local Learning and Employment Network (WSMLLEN) to promote the MATES Mentoring program through print, advertising, digital and social media.
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