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
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
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, Professional experience, Specialist expertise, Interests/Hobbies Fun fact.
Expectations
Your lived experience
In completing the registration form, please share some specific information regarding any identities or experiences (race, sexual orientation, gender, cultural, ability/disability, neurodiversity, parenthood, carer, veteran, first in family to study, linguistic, etc) in particular that you would like to support or connect with in a Mentor - Mentee framework.
CV (optional)
Please provide a link to either your CV or LinkedIn profile.
Mentor level (I am a) —Please choose an option—ProfessionalJunior Manager/Team leaderMiddle ManagerSenior ManagerExecutive TeamManaging Director/CEOPrivate business owner/Consultant
Mentor skills (I can provide advice on) 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 stakeholders
Select as many as you like.
Mentoring experience
Mentor Goals (As a mentor, I am looking to) 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 ForwardChoose Another
Mentoring Format
Please refer to our Mentoring Page to learn about our different Mentoring formats, including our GEM Program.
Mentor Format (My 1st preference for mentoring is) —Please choose an option—Mentoring CirclesIndividual (1:1)
Mentor Format (My 2nd preference for mentoring is) —Please choose an option—Mentoring CirclesIndividual (1:1)
Our new GEM (Gender Equality Men) Program seeks to support men across operations with the tools, resources, and expertise to step-up as gender equality advocated in their workplaces. The GEM Program will run along the same timeframe as our standard NAWO Mentoring Program (February to October) and comprises of seven sessions.
I want to be/nominate a mentor for the GEM Program. YesNo
Session limitations (Are there any considerations which affect your availability?)
E.g. shiftwork, caring responsibilities. If yes, please provide details.
Do you need any access support to participate in these mentoring sessions (captioning of chats, copies of transcripts to process discussion later, etc)? YesNo
Mentoring Motivations
If you are not already subscribed to receive communications from NAWO, would you like to be? YesNoAlready subscribed
Submit
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