Mentor Program – Mentor Application

Name*
Date of Birth*
DD slash MM slash YYYY
Gender*
Suburb*
Email:*
Phone number:*
Current club and coaching position*
Coaching qualifications*
Program Interest and Commitment
Why would you like to participate as a mentor?*
What would you consider to be the most important qualities of a mentor?*
What type of person would you like as your mentee?*
How would you prefer to interact with your mentee?
- Face to Face
- Over the phone
- Text Messaging
- Email
- Other