Diversi-tees

Mentee Application Form 2011/12

Before completing the form please ensure that you have read the information about the scheme on: http://www.tees.ac.uk/depts/careers/mentoring.cfm ELIGIBILITY The scheme is open to undergraduate and postgraduate students who are: UK/EU student (or with unrestricted right to live and work in UK) (Please confirm you meet this criteria): (You may be asked to produce further information about your residency status at interview) AND You meet at least ONE of the critera below (select all that apply to you): Black and minority ethnic (BME) Mature student (21 or over on entry to undergraduate study) Disabled student The scheme is open to undergraduate and postgraduate students who meet the above criteria

PERSONAL DETAILS
First Name: Term Address: (include postcode) Telephone: Student Number: University email: Personal email: syed Surname: ahmed

29-31 park road, hartlepool ts247pw j9127456 Mobile: 07401973466 09/10/1983

Date of birth: j9127456@live.tees.ac.uk syed.waqasahmed@yahoo.com

Title of CURRENT degree/postgraduate course: Year of study: First Second Final Postgraduate

Postgraduates only: Title of undergraduate course: Bsc Age on entry to undergraduate course: economic, statistics,mathematics

Gender:

Male:

Female: No No

Do you have your own means of transport? Yes Do you have a disability? If Yes please specify: Yes

Do you require any special assistance or facilities e.g. interpreter, wheelchair access? Yes No If yes please specify:

Do you permit us to share any information about your disability requirements with your mentor, for support reasons only? Yes No

CAREER INTERESTS In order to help us to match you to a mentor please indicate up to three career areas/organisations in which you are most interested e.g. Finance, HR, IT, General Management, Law-related, Marketing, Social Work, Local Government, Police, Prison Service etc)
1 2 3

Finance Management Business

What help do you think you might need to achieve your career goals? Please tick any of the following areas on which you would like advice/support: Insight into specific career/company CVs and Applications Self presentation skills Time management and prioritising deadlines Work shadowing/experience Other: Career planning and professional development Interview techniques Communication Skills Networking opportunities Equality and diversity issues

PERSONAL MOTIVATION
Your comments will be used in the selection and matching process. Please give as much information as possible to demonstrate your commitment and motivation:

(A)

Why do you wish to be involved in the Diversi-tees Mentoring Scheme? this is a great opportunity to learn and use your knowledge

and skills , you have got from your education and past experience.

(B)

What do you hope to gain by participating? experince and understanding of different culture

(C)

What makes you an ideal candidate for the Scheme?

i am young and self learner and my education and past experience make me to more appopriate candidate.

How did you find out about Diversitees?

university websites

Ethnic Origin: (Please tick box which best describes your ethnic origin) Bangladeshi Black other Indian Prefer not to say If Other, please give details Black African Chinese White Black Caribbean Pakistani Other

MENTEE DECLARATION If selected to participate in Diversi-tees my commitment is to : Attend the induction training and introduction event at the beginning of the Scheme Provide feedback during the Scheme and by writing an End of Scheme report with my mentor Arrange a minimum of 4 two hour meetings with my Mentor and maintain regular contact with them Attend the Celebration of Achievement at the end of the Scheme Inform the Scheme Co-ordinator if I have any problems relating to my participation in the Scheme Signature:...........................................................Date: 23/05/2011................................ Thank you for completing this form. We will contact you as soon as possible to arrange an interview. Please print, sign and return the completed form to: Sue Stockwell, Diversi-tees Co-ordinator Teesside University Careers Service Student Centre Borough Road Middlesbrough TS1 3BA. If you have any queries please do not hesitate to contact me on: Tel: 01642 342283/60 Fax: 01642 342261 s.stockwell@tees.ac.uk Note: Information will be held by the University in compliance with the provision of the Data Protection Act 1998.