SEO Professional Services Mentoring Registration 2010
Thank you for your interest in being an SEO Mentor
Please take a few minutes to complete this form. It will help us find the best mentee match for you. The more information you give us, the better job we will be able to do in finding a mentee who you can best support.
Questions marked with a
*
are required.
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1
Name(s)
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2
Surname
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3
Firm
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4
Division
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5
Position/Title
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6
Desk/Function/Role
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7
Phone Number
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8
E-mail Address
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9
Gender
Male
Female
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10
Are you an SEO alumnus?(Check any)
Yes
No
11
If yes, which year and programme?
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12
Please select the national/ethnic background(s) that best describe you. Please feel free to tick more than one box. (
NOTE
: The box that comes BEFORE the national/ethnic background corresponds to that background) (Check any)
Black-British (African descent)
Black-British (Caribbean descent)
Black Caribbean
Black African
Indian
Pakistani
Bangladeshi
Sri Lankan-British
Pakistani-British
Bangladeshi-British
Sri Lankan- British
Indian-British
Vietnamese
Singaporean
Malaysian
Japanese
Chinese
Korean
Taiwanese
South East Asian
South East Asian- British
Chinese-British
European (please specify below)
Mixed (please specify below)-
White-British
White- Other (please specify below)
Latin American (please specify below)
Other, please specify below
13
Other national/ethnic background
*
14
Please tick your interests/hobbies. (
NOTE
: The box that comes BEFORE an interest corresponds to that interest)(Check any)
Sports
Sports-Football
Sports- Cricket
Sports - Other (please specify below)
Arts- Visual
Arts- Theatre
Arts- Dance
Arts - Music
Outdoors - Hiking
Outdoors - Skiing
Outdoors - Camping
Outdoors - Water Sport
Film
Wine
Reading
Dining out
Hosting
Chess
Politics
Debating
Gardening
Travel
Crafts
Collecting
Yoga
Religion
Volunteering/Fundraising/Charitible causes
Activism
Other (please specify)
15
Other interests/hobbies
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16
University
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17
Undergraduate Degree Course
*
18
Please specify how many students you will be happy to mentor during the summer
1
2
3
Please rank the type of mentee needs you could best support (1 indicates needs you could best support, 5 indicates needs you could least support):
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19
Someone who is bright yet rather unexposed to the world of professional services, and might need help with polish or fitting in.
1
2
3
4
5
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20
Someone who just needs access to resources and my blunt honest advice/feedback, but who does not require significant interpersonal/emotional support.
1
2
3
4
5
*
21
Someone from my own ethnic group
1
2
3
4
5
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22
Someone who is quiet and who needs help being assertive, building networks, meeting people.
1
2
3
4
5
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23
Other, please specify below
1
2
3
4
5
24
Additional Information
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