Mentee Form
Contact
First Name
Last Name
Address
Tel:
Mobile:
PA Name:
PA Email:
PA Email:
PA Tel:
How would you prefer us to make contact with you?:
Do you have a Linked In profile? If so, please give your URL
Experience
How long have you worked in the energy sector in total?
Have you worked in any other sectors during your career? Please summarise the other sectors in which you have worked, giving an indication of the length of time you worked in these areas.
Biography (Please provide a short summary of your background – key points and experience, including a brief indication of the reasons for any career changes you have made, and what you see as your key achievements so far)
Professional bodies and organisations: Do you hold any professional qualifications, memberships or designations?
Position
Position / title
Date you took up this post
Company Name
Sector
Operational area
Please give an outline of your current role and areas and scope of your responsibility.
Your application
How would you ideally like your career to develop? Please tell us about any particular career goals you have set yourself and where you think you would like to be in 5 years’ time.
How do you think you would benefit from being mentored? Please list up to five key areas you would like to work on with a POWERful Connections mentor.
Has a POWERful Connections mentor already agreed to mentor you? If so, please provide further details, including their name, company, position and contact details.
Your proposer
Please provide details of a senior individual who is willing to support your application to be mentored under the POWERful Connections initiative. Your nominated proposer should be a line manager, head of department or outside sponsor or referee who is in a position to know you, your work and your potential well and should give their endorsement of your application by signing below. The proposer will be contacted in due course, to answer a few short questions in support of your application.
Proposer Name
Position / title
Organisation
Telephone number
Relationship to mentee
Attach your CV
I wish to apply to be mentored under the POWERful Connections scheme. I understand that the information I have provided in this form will be used by the Energy Institute to take forward my application and that details of my career and background may be be forwarded to one or more potential mentors, who will treat my documents in strict confidence. I understand that the information I have submitted will be securely stored by the EI on behalf of POWERful Women, and will be used to monitor and evaluate the success of the scheme. My contact data may also be used to enable the EI to send me news and updates on the POWERful Women initiative. As part of my application I agree to contribute to the evaluation of the scheme, and on completion of the programme to mentor at least one other women in energy within 12 months. I also agree to provide updates on my progress after graduation from the scheme if asked to do so.