ECWA Next Generation Schools Program

Mentor Registration

Register as an industry mentor for the Next Generation Schools Program.

Personal

Title

Preferred Name

Family Name

How do you describe your gender?

 

Are you of Aboriginal or Torres Strait Islander descent? If yes, share your language group(s)? (optional)

Country of Origin (optional)

What other languages can you speak? (optional)

Contact

Mobile Number

Primary Email (Work)

Alternate Email (Personal) (optional)

LinkedIn Profile Link (optional)

Organisation

Organisation

Job Title / Position

What type of organisation do you work for?

Choose: Corporate / Utility / Government / Academic / Non-profit / Other

What industry sector do you work for?

Choose: Electricity / Oil & Gas / Mining / Renewables / Research / Policy / Education / Other

What is your role seniority? (optional)

Choose: Junior / Mid / Senior / Executive

How did you hear about us? (optional)

Choose: Friend or Colleague / Employer or Organisation / Social Media Post / Event or Conference / Online Search or Website / Other

WWCC

Do you have a valid Working With Children Card?

Please upload a copy of your Working With Children Card

[Upload via online form — file attachment]

Program

Please advise of your education pathway (optional)

Have you been a program mentor before?

Would your workplace be happy for you to take time out to attend school visits?

What is your preferred school location?

Would your company provide a display for the Student Expo Day?