Moniack Mhor Made to Measure Mentoring – Provisional information
Please take the time to fill in this form and please provide as much information as possible about your work and what you hope to achieve through your mentoring arrangement. The more we know, the better our organisation and mentor can support you and your work in progress.   
Name		
Email 		
Tel no.		
Postal address		
		
1.	Can you please briefly tell us what you are currently working on and what stage you are at with your project?	

	
2.	Who would you like to select as your mentor?	

3.	In order of priority, can you tell us what you hope to get from your mentoring arrangement?	

1.

2.

3.

4. 

	
4.	If not detailed above, please indicate what you would like your mentor to focus upon in your work.

	
5.	How many mentoring sessions would you like? (Please note sessions can also be booked as you go along)

6.	Are there example models on our website that would fit your needs? Please list those of interest.

	
7.	If you cannot see the right fit for you in our examples, can you suggest another format to support your work? 

	
8.	How would you like to conduct your conversations with your mentor? 
               (Please delete as appropriate)	Zoom              
Telephone             
Other (please provide details)

9.	When would you like to schedule your first session? 

10.	Do you have any specific learning or access requirements that you feel we as facilitators or your mentor should be aware of? Please include details. 
                    We ask this question so that we can 
               ensure that we can provide the best 
               support possible.
		
11.	Have you visited Moniack Mhor, or been supported by us in any way before? Please give brief details. 
		
12.	Is there anything else that you would like to share at this point?	

	

Many thanks for taking the time to fill in this form. We or your mentor will likely come back to you to ask more specific questions once we have organised your mentoring arrangement.