LFL Mentor Application Form - Cohort 1

Leicester's Future Leaders Mentoring – Mentor Application Form

Leicester’s Future Leaders is DMU’s ground-breaking project, supported by the Office for Students, that aims to increase the progression of Black, Asian and Minority Ethnic graduates into leadership roles in Leicester.

LFL is a project that aims to measure specific impact and outcomes. Therefore, all the questions asked are necessary to be able to effectively measure meaningful and positive change.

Any information with an exclamation mark (!) will be shared with your future mentee to help facilitate the partnership.

Please note that this form will time out and not save any changes. We therefore recommend you copy and paste sections that you feel will require more time.

Download the job description: Mentor-Role-Job-Description.doc

A) Your Details

If you select 'Other' please type in the space provided

B) Your Employment Details:

C) More about you

*D) Mentor Preferences

As a result of Covid-19 you may be unable to meet your mentee due to localized government restrictions, being in a high-risk category or do not feel comfortable or safe to meet your mentee in a public space. We expect meetings to be conducted via video call.

Please provide contact of two professional references to comment on the suitability for you to become a mentor.

Reference 1

Reference 2

E) How did you hear about us?

F) Data protection

The data you supply on this form will be used as follows:

  • To inform you about mentoring activities and events such as training, group mentoring, workshops
  • To match you to a suitable mentee
  • To notify you of your match, check your progress and ask for feedback
  • To generate meaningful statistics on the uptake of the scheme and use this to inform future delivery and measure the impact of mentoring

Your LFL record will be processed in compliance with current data protection legislation as follows:

Data will be securely stored and updated on an annual basis.

To find out more, please see Data Protection at DMU web page.