Application-to-be-mentored

							                                             Better opportunities for civil servants, better services for the public


                  CSEE Mentoring Project: Mentoring Request Form

Name

Department
Grade
(Please use old Civil Service equivalents,
e.g., AO, HEO etc)

Current role description
Email address
Telephone number

Location (City/Town)

What do you want to gain from being
mentored?
What specific skills, subject interest or
areas of expertise would you like in
your mentor?
What means of mentor contact would
you consider?
(e.g. face to face only, telephone, email)
Please specify any considerations that
would need to be made in order for
you to be involved in the project. (e.g.
due to a disability, health problem,
religion / belief, travel restrictions)
Line Manager’s details                       Name :
(By providing these you are confirming
that your involvement in the mentoring       Tel :
project has been discussed and agreed        Email :
with your Line Manager)

       Once you have completed this form, please e-mail to ian.barton@hmrc.gsi.gov.uk