Please fill in this form if you are seeking to be mentored or to be a mentor.
Your Name
Home Address
Home Phone
Mobile
Your Email
Age 18-2526-3536-4555+
Marital Status
Occupation
Interests & Hobbies
Mentoring & You - Select 1 as a MENTOR: Not ApplicableOlder to YoungerPeer MentoringShared Mentoring
Mentoring & You - Select 1 if you wish to be a MENTOREE: Not ApplicableOlder to YoungerPeer MentoringShared Mentoring
If you would like to find a mentor, what are you hoping to achieve through having a mentor
Is there someone at VPBC who comes to mind when you think of a mentor for yourself? if so, could you name at least 2-3 people
Is there a time you would prefer to meet?: Morning (Weekdays)Evening (Weekdays)Morning (Weekends)Evening (Weekends)Anytime
If you have already organised a mentoring group - please specify the group members and who is the mentor
If you are interested in becoming a MENTOR, please provide the names and phone numbers for two referees. (at least one should be a pastor at VPBC) Referee 1:
Referee 2:
Do you have a certain passion or area in which to mentor? Eg: Youth, Young Adults, Young Mums, Church Leaders, Parenting or Marriage etc::