For further details please contact:
RAF Leadership Centre
Warrant Officer David Smith
Tel: 01400 266607
ldt-wo@cranwell.raf.mod.uk
CHALLENGE CYMRU
Mentor Application Form
2010-2011
PART ONE
PERSONAL DETAILS
This information is for monitoring and mail purposes only and will not be used as a basis for selection.
Have
you previously participated in Druidstone Plus or Challenge Cymru?
Full name:
Yes
No
Name you wish to be
Do you consent to your contact details being sent on to fellow participants prior to
know by:
the start of the programme? This will enable you to co-ordinate transport/travel
together, should you wish.
Yes
No
T-shirt size (unisex):
XS
S
M
L
XL
XXL
3XL
Full Work Address:
Postcode:
Work Telephone:
Mobile Telephone:
Email:
Fax:
Staff Number:
TLB:
PART TWO
SUPPORTING INFORMATION
Individuals wishing to participate in this 2-week development programme should complete this section in conjunction with their
Line Manager.
To be completed by the job holder
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Are you currently on Restoring Efficiency?
1.
Yes
No
Please detail why this training is needed. (This should be reflected in your personal training and development
plan).
2. Challenge Cymru involves a range of individual and team based activities, which cover the following
competencies:
Working Together
Leadership and Developing People
Communicating and Influencing
Analysing and Using Evidence
Improvement and Change
Planning and Managing Resources to Deliver Business Results
Programme and Project Management
Please tick the 3 competencies you wish to focus on. This will aid the action planning process and enable Prince’s
Trust staff to give you more personalised feedback.
3. Please expand on those areas you have ticked by stating what benefits and improvements you would hope to
make both for yourself and your job / unit / branch.
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2
PRE COURSE EVALUATION – to be completed in agreement with your Line Manager
You will find as follows a list of statements, the question you must answer is “How well do I demonstrate this?” Using the six
options given below, you are asked to rate yourself on the scale provided. An explanation of the scale is given below:
1. never
2. almost never
3. sometimes – is demonstrated on some occasions
4. usually – more often than not
5. nearly always
6. always – demonstrated where appropriate
Please indicate your choice on the form by ticking the appropriate number.
You do not need to spend too long on any particular question. Try to answer the questions as honestly as possible. In this way
the results gained from completing both pre and post course evaluation will be most useful for your personal development.
Working Together
never
1.
1
2
3
4
5
6
2. Willingly accepts responsibility for delivering own and team
1
results
2
3
4
5
6
3. Takes account of the contributions, experience and
background of others
1
2
3
4
5
6
4. Willingly keeps others informed of progress and possible
problems
1
2
3
4
5
6
5. Encourages team members to take responsibility for their
own results
1
2
3
4
5
6
Leadership and Developing People
never
1.
Actively works with others to achieve departmental aims
Aware of own leadership style encouraging ideas and
involves other in decisions
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1
always
always
2
3
4
5
6
3
2. Assists others to develop knowledge and skills to improve
team performance
1
2
3
4
5
6
3. Provides encouragement and constructive feedback
1
2
3
4
5
6
Communicating and Influencing
never
1.
1
2
3
4
5
6
2. Develops good working relationships
1
2
3
4
5
6
3. Asks questions to check understanding
1
2
3
4
5
6
4. Uses appropriate method, language and style of
communication for the situation
1
2
3
4
5
6
5. Listens to others’ points of view
1
2
3
4
5
6
6. Checks information for accuracy and consistency
1
2
3
4
5
6
Analysing and Using Evidence
never
1.
Takes positive steps to deal with feedback
Takes considered and timely decisions within the limits of
own authority
always
always
1
2
3
4
5
6
2. Identifies main parts of and solutions to a problem
1
2
3
4
5
6
3. Checks sources of evidence for validity and accuracy
1
2
3
4
5
6
Managing Customers & Suppliers
never
1.
1
2
3
4
5
6
2. Effectively manages expectations explaining what is and
what is not possible
1
2
3
4
5
6
3. Works effectively with different organisations to achieve a
common goal
1
2
3
4
5
6
Improvement and Change
never
1.
Builds and maintains productive working relationships
always
always
Responds quickly, flexibly and positively to change,
approaching issues with an open mind
1
2
3
4
5
6
2. Understands the need for change and puts into practice
new ways of working
1
2
3
4
5
6
3. Considers the way things are done and suggests change
where appropriate
1
2
3
4
5
6
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4. Considers change as an opportunity to learn, develop and
practice new skills
1
2
3
4
5
6
5. Encourages and supports others to become fully involved
in the change process
1
2
3
4
5
6
Planning and Managing Resources to Deliver Business
Results
never
1.
Understands and can clearly explain the role of self and
others in delivering results
always
1
2
3
4
5
6
2. Seeks and acts on feedback to improve performance
processes
1
2
3
4
5
6
Programme and Project Management
never
1.
Plans ahead identifying possible risks and sets realistic
targets
always
1
2
3
4
5
6
2. Acknowledges the need to actively involve key stakeholders
1
when managing projects
2
3
4
5
6
3. Able to link issues and recognises implications of actions
taken on other areas
2
3
4
5
6
1
Total:
To be completed by the Line Manager
4. Please be aware that due to the high volume of applicants Challenge Cymru does not have a formal selection
process and is thereby filled on a first come first served basis. Once you have discussed and agreed this
development need with your member of staff, please state below why you are supporting this application.
Applicant’s signature:
Line Manager’s name:
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Line Manager’s signature:
Line Manager’s work address:
Line Manager’s phone number:
FUNDING – to be completed in conjunction with your Line Manager and Budget Manager
The cost of Challenge Cymru is £1,250 per individual. Individuals interested in attending must obtain funding authorisation from
their Budget Manager. All Travel and Subsistence and incidental expenses, must be met by the local budget, for which budgetary
authority must be sought when applying.
Please confirm that you agree to meet these costs:
Budget Manager’s name:
Budget Manager’s signature:
Budget Manager’s address:
Budget Manager’s civilian phone
number:
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PART THREE
PRIVATE AND CONFIDENTIAL
MEDICAL INFORMATION
This information is needed in addition to the Princes Trust ‘Next of Kin and Medical Details’ Form
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Name:
Are you water confident?
Yes
No
Yes
No
Do you have a heart condition or any circulatory problems?
Yes
No
Do you have epilepsy or any other neurological disorder?
Yes
No
Are you or could you be pregnant?
Yes
No
Do you have any muscle or joint difficulties that affect your ability to carry or lift
anything?
Yes
No
Is there any other information you think we should know?
Yes
No
Do you have asthma
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PART FOUR
PRIVATE AND CONFIDENTIAL
INFORMATION AND CONSENT
Data Protection Act 1998
I confirm that I give my consent to The Prince's Trust to collect and store the information given by me. I understand that this
information will be used in connection with programme participation and management and for statistical and fundraising
purposes. I understand my right to request a copy of the information held about me by The Prince's Trust.
In accordance with the Data Protection Act 1998, the Ministry of Defence will collect, use, protect and retain the information on
this form in connection with all matters relating to our personnel administration and policies.
Signed:
Release and Assumption of Risk
I am aware that my part in activities organised by The Prince’s Trust Cymru (or as appropriate) may expose me to risks which
are beyond the control of the Leaders and that I may be in remote areas without medical facilities. I accept that the Leader has
the right to terminate my participation in any project because of health or physical condition or unwarranted conduct and I
agree that the decision of the Leader shall be binding on me.
I have had explained to me the possible risks arising from my involvement in activities organised by The Prince’s Trust Cymru. I
fully understand the terms of my participation and accept those risks.
Signed:
Print name:
Date:
FINAL APPLICATION CHECKLIST
Mentor Application Form
Next of Kin and Medical Details Form
Publicity Consent Form
Please return all the above documents in hard copy to:
Warrant Officer David Smith
RAF Leadership Centre,
GETC, Room 221B
Trenchard Hall, RAFC Cranwell,
Sleaford, Lincolnshire,
NG34 8HB
Receipt will be acknowledged within 5 working days
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