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* 1. Name

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* 3. Role

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* 4. I am clear about the purpose of this professional development opportunity 

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* 5. I am aware of the dates of this professional development opportunity

Thursday 28 January 2021, 4.00-5.15pm
Thursday 4 March 2021, 4.00-5.00pm
Thursday 22 April 2021, 4.00-5.00pm
Thursday 17 June 2021, 4.00-5.00pm


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* 6. I understand that places are limited and I will give 48 hrs notice if I need to cancel should I no longer be able to attend 

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* 7. What is your motivation for attending these session?

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* 8. What is your Mentor experience?

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* 9. How much Mentor experience do you have?

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* 10. If you have been a Mentor previously, what group did you mentor?

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* 11. What's the outcome you’d like to get to by the end of the session?

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