First Name
Last Name
Gender —Please choose an option—MaleFemaleNon-binaryPrefer not to label
Organisation (I work for)
Job title
Current role
Mobile
Office phone number (optional)
Email
Secondary email
Job Function (My job function is) —Please choose an option—Corporate Affairs/LegalCustomer ServiceDistribution/Logistics/TransportEngineeringFinanceHuman ResourcesITMarketingPlanningProcurement/SourcingProductionQualityResearch & DevelopmentSalesWarehousingOther
Select one or add your own if not listed
Other
Industry (The industry I work in is) —Please choose an option—Accommodation & Food ServicesAdministrative & Support ServicesAgriculture, Forestry & FishingArts & Recreation ServicesConstructionEducation & TrainingElectricity, Gas, Water & Waste ServicesFinancial & Insurance ServicesHealth Care & Social AssistanceInformation Media & TelecommunicationsManufacturingMiningProfessional, Scientific & Technical ServicesPublic Administration & SafetyRental, Hiring & Real Estate ServicesRetail TradeTransport, Postal & WarehousingWholesale TradeOther
Manager name
Manager email address
Work experience (Number of years work experience) —Please choose an option—< 1 year1 - 3 years4 - 5 years6 - 10 years11 - 15 years16 - 20 years21 - 25 years> 25 years
Select one
Business address
Business suburb
Business Postcode
Business state —Please choose an option—VictoriaNew South WalesACTQueenslandNorthern TerritoryWestern AustraliaSouth AustraliaTasmania
Regional area (I am based in the following regional location) —Please choose an option—NSW Central CoastNSW North CoastNSW RiverinaQLD MackayQLD Mt IsaSA BarossaSA WhyallaVIC BallaratVIC GeelongVIC GoulburnWA BunburyWA PilbaraOther
Working style Select your working styleDetail OrientedQuick To Make Decisions And ActEnergetic And OutgoingA Team Player
If you identify with more than one, please pick the one you MOST identify with.
Biography
Work history, Leadership experience, Professional experience, Specialist expertise, Interests/Hobbies Fun fact.
Expectations
What you expect to gain as a mentoring program participant.
LinkedIn (optional)
Please provide a link to your LinkedIn profile.
I have line manager support/commitment for my active participation in the program, including scheduled time off the floor/other work, and tech support and equipment? YesNo
I commit to furthering my professional development and will prioritise the time to attend the program sessions YesNo
Do you need any access support to participate in these mentoring sessions (captioning of chats, copies of transcripts to process discussion later, etc)? If yes, we will be in touch to discuss how we can best support you. YesNo
I understand that a program fee will apply YesNo
Mentee level (I am a) —Please choose an option—Entry Level/GraduateTeam memberProfessionalJunior Manager/Team leaderMiddle ManagerSenior ManagerExecutive TeamManaging Director/CEOPrivate business owner/Consultant
Mentee skills I would like to strengthen MAXIMISING YOUR EFFECTIVENESS (MYE)• Building reputational capital• Building meaningful networks• Communicating with purposeADAPTIVE & COURAGEOUS LEADERSHIP (ACL)• Authenticity, Values and Motivations• Leadership legacy and vision• Taking decisive action• Having courageous conversationsBUILDING AND LEADING DIVERSE TEAMS (BLDT)• Understanding and managing your own bias• Forming diverse teams for high performance• Effectively leading diverse teamsBUSINESS & TECHNICAL ACUMEN (BTA)• Creativity and innovation• Metrics and measures that matter• Business partnering (cross-functional)• Project ManagementINFLUENCE & NEGOTIATION (IN)• Effectively leading diverse teams• Championing Change• Negotiation strategies for win-win• Identifying and influencing key stakeholdersOther
Select as many as you like.
Mentee Goals (As a mentee, I am looking for) Assist With Career ProgressionProvide Industry InsightsHelp With Entering The IndustryProvide Professional DevelopmentEnhance My NetworkImprove Skills GapsHelp Develop A 5 Year Career PlanConnect With The Next GenerationPay It ForwardOther
For the first time, NAWO will be able to offer sponsored places to women based in Victoria and working in manufacturing and energy who are seeking mentorship. We also have a small range of opportunities for women wishing to transfer into the energy sector. The sponsored program will target regional women in the above industries and women working in SMEs, although it is not limited to these areas. Would you like to apply for an Office for Women Sponsored Place? YesNo
Are you a woman (including trans or gender diverse identities) working in Victoria? YesNo
Do you work in (please tick which applies) Energy sectorManufacturing sector
If you are eligible for a sponsored place we will be in touch with further details.
Do you want to work in/transition to the energy sector? YesNoN/A
Designated Career Stage Circles - would you like to participate in a Mentoring Circle with a focus on any of the following career stages? YesNo
If yes, please tick any that apply: Digital OperationsDesigning for Inclusive Culture (HR, WHS, and Corporate roles)Aspiring Leader (not currently in a leadership role)Managing Work and Carer CommitmentsNew Leadership Role (just started a leadership role)Experienced Leaders Looking to the C SuiteInclusive Leadership (how to lead for diversity and inclusion)New to Operations (new to your field or industry)
Mentoring Format (My 1st preference for mentoring is) —Please choose an option—Mentoring CirclesIndividual (1:1)
Mentoring Format (My 2nd preference for mentoring is) —Please choose an option—Mentoring CirclesIndividual (1:1)
Session limitations (Are there any considerations which affect your availability?)
E.g. shiftwork, caring responsibilities. If yes, please provide details.
Mentoring Motivations
If you are not already subscribed to receive communications from NAWO, would you like to be? YesNo
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