Career Mentor Scheme
Mentor Registration Form
Thank you for kindly offering to give your time to mentor a University of Exeter student. We are
extremely grateful to our many dedicated Mentors, which help to make the scheme a real success.
In order to match you to a student effectively and make the most of your time as a Mentor we would
like to gather some further information about you.
Please provide details you are happy for us to share with your mentee.
Once completed, please return this form to:
Jenny French Career Zone Assistant (Mentoring & Alumni Liaison)
Career Mentor Scheme
Employability & Graduate Development
University of Exeter, Room K6 Kay Building
North Park Road, Exeter
EX4 4QF
Alternatively, email this form to: exetermentorscheme@exeter.ac.uk or fax, 01392 722083
Current Situation
Full Name
Job title
Organisation
Main responsibilities
Address (Business)
Telephone
(Business)
Email
(Business)
Current profession:
Education, Training and Development
Degree / other qualifications
Dates
I am an alumnus/alumna of the University of Exeter
Previous Employment (Please state your most relevant work history in reverse chronological order)
Career Mentor Scheme Registration Form
Last updated July 2011
Job Title &
Organisation
Main responsibilities
Dates
Please tick the employment sectors you feel you can provide help with:
Advertising/Marketing/PR
Business/Management
Charity/Voluntary
Conservation/ Environment
Consultancy
Education
Engineering
Finance/Accounting
Healthcare/Psychology
Hospitality/events management
Human Resources
IT
Law
Leisure, sport & tourism
Linguistics
Mining
Museums
Media – TV/Film/Radio
Politics
Publishing/journalism
Science
Others not listed above:
Please answer the following questions:
What are your best memories of university and/or your first career job?
What is the most important thing you learned during your time at university? (if applicable)
What is the most important thing you learned during your first career job?
What is your most important accomplishment in your career so far?
In what ways do you think you may be able to help a student? Please tick all that apply.
Insight into a specific sector and/or organization
Advice regarding recruitment activities (interview technique, application forms)
Personal support
Academic support
Provide networking opportunities
Provide work experience/shadowing
Other not listed above (please state here)
Do you have a preference to help a certain type of student? If so, please state this and why.
(We are unable to guarantee an exact match)
Career Mentor Scheme Registration Form
Last updated July 2011
Thank you for your time.
By completing this form, you agree to be matched with a University of Exeter student and as
part of this process, to share this information with your mentee. You can withdraw your
participation at any time by contacting Jenny French in Employability and Graduate
Development: exetermentorscheme@exeter.ac.uk or 01392 722034.
Unfortunately, we cannot guarantee that a suitable student will be available for you for the
next recruitment round. We will endeavor to let you know if we have been successful at the
earliest opportunity at the beginning of the year.
Photo Disclaimer
During your participation in the Career Mentor Scheme, we may ask for you to be photographed so
that we can use it for marketing purposes. This may take the form of entries on websites or printed
media and will be used primarily to encourage other students and Mentors to participate in the
Scheme.
Please sign below to confirm that you agree to participate in any recording/videoing/photography for
the purposes of marketing and that you agree to participate in the Career Mentor Scheme.
Signed:
(Please print if using a computer)
Date:
Equal Opportunities
We are keen to know whether we are reaching as wide a range of Mentors as possible. To help us,
please answer the following questions:
Disclaimer: All the information received on this form will be treated in the strictest of confidence. Your
responses will be held anonymously on a database and will be used only for project reporting purposes.

Are you male / female?

Do you have a disability?

Ethnic Origin: (Please highlight the necessary option from below or write here)
Yes / No
ASIAN OR
ASIAN BRITISH
Indian
BLACK OR
BLACK BRITISH
Caribbean
CHINESE OR OTHER
ETHNIC GROUP
Chinese
Pakistani
African
Any other
Bangladeshi
Any other black
Background
Any other
Asian
background
Career Mentor Scheme Registration Form
Last updated July 2011
MIXED
WHITE
White & Black
Caribbean
White & Black
African
White & Asian
British
Any other
mixed
Background
Irish
Any other
white
Background