Working Together – Mentor Application

Thank you for your interest in becoming a mentor for our Working Together mentorship programs to support people aged 50+ looking to enter/re-enter the workforce.

To register your interest as a mentor, please complete the form below.

Once you have registered your interest, we will be in touch to discuss your application.

We are looking for people who are:

- Passionate about supporting people aged 50+ to get back into the workforce

- Willing to participate in approximately 8-10hrs of facilitated mentor training (online)

- Available 2-4hrs per month to support your mentee for a minimum of 6 months

- Able to meet in the North and Western suburbs of Melbourne (Including the Cities of Hume, Brimbank, Moreland, Moonee Valley and the Shire of Macedon Ranges)

Expression of Interest Form for Mentors

(Please complete and submit this form to express interest in becoming a Mentor under this program)

Personal Details

Last Name

First Name

Date of Birth

Gender

E mail

Phone

Street Address

Suburb or Town

Local Government Area (LGA)

State/Territory

Post Code

Personal Background

1. What is your country of birth?

2. What languages do you speak at home?

3. Please select your Indigenous status:

4. Do you have any disabilities, impairments or conditions?

If yes, please provide details

5. Please select the option that best describes your individual (not household) main source of income:

6. How would you rate your digital skills in using a computer or a tablet/iPad?

7. Please tick if you are:

8. Please note: Carers are people who provide unpaid care and support to family members and friends who have a disability, mental illness, chronic condition, terminal illness, an alcohol or other drug issue or who are frail aged.

Are you a carer?

9. Please note: LGBTIQA+ stands for lesbian, gay, bisexual, transgender, gender diverse, intersex, queer, asexual and questioning

Do you identify as being part of the LGBTIQA+ community?

Work and Education

1. Are you currently employed?

2. Please provide a brief history of your work experience. (Please limit your answer to 6 lines or less)

3. What is the highest qualification level you hold (if any):

Program-Specific Questions

1. Why you would like to become a mentor for a Working Together project? (Please limit answer to 6 lines or less)

2. How did you hear about the Working Together projects?

Please provide details

3. Do you face any barriers we could help you overcome to participate as a mentor in Working Together?

(e.g. Accessibility, AUSLAN, travel, transport, childcare, reading and writing, English language skills, or other)

If ‘yes’, please specify:

4. What days/times are you NOT available to participate in Working Together program activities, such as weekdays, weeknights or weekends? (Please note that we cannot guarantee your preferred days)

Terms and Conditions

I understand that this is an Expression of Interest Form only and that COTA Victoria will be in touch with myself to determine my suitability to join a Working Together project. I agree that Council on the Ageing (COTA) Victoria) collects my personal information for the purpose of joining a Working Together project only and will store my information as per COTA Victoria's Privacy Statement.

I agree with above mentioned terms and conditions