Please Complete the Following Proforma Which Provides Useful Information Relating to Your

Pivot:

theUniversity of Oxford Mentoring Scheme for BME Staff

Mentee Application Form: Pathway A

For Pathway A, you must be employed by the University of Oxford or one of its colleges and identify as BME. You can be at any job grade. You will join a group of three or four other mentees with a BME mentor, to network with similar colleagues, get support to consider your personal and professional development, or use the group as a sounding-board to discuss work-related issues or challenges.

The information you provide is strictly confidential andwill beavailable only to those runningthementoring scheme in the Equality and Diversity Unit to assist us in matching you with your mentor.

Name:

Department:

Location(Central Oxford, JR, Old Road Campus, South Parks, other):

Job title:

Work tel. no:

E-mail address:

Do you have a preference for the timing of your meetings? e.g. a preferred day of the week, mornings or evenings

Please describe what you hope to gain through the mentoring scheme

Please complete the brief questionnaire below.This is to help you reflect on your priorities so that you can be clear about what you want from the scheme, and to help us match you with other mentees. We will also use the (completely anonymous) results to evaluate the impact of the mentoring scheme by comparing it with a questionnaire that we’ll send you at the end of the initial 12 month mentoring period.

Thinking about where you are now, what barriers and opportunities do you see for advancing your career?

Please return your completed proforma to

by Friday 3 June 2016