IDM Reverse Mentorship Programme
Full Name
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Title (Example: Prof, Mrs, Mr)
First Name
Last Name
Email Address
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Please provide your UCT affiliated email address
Involvement in IDM community
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IDM Postgraduate Student
IDM Postdoctoral Research Associate
IDM PASS Staff Member
IDM Academic Staff Member
Primary Affiliation (Member Group/Division/Department)
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Involvement in Reverse Mentorship Programme
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I want to participate as a Learner (Senior)
I want to participate as a Teacher (Junior)
Your Demographics: Gender
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Please Select
Female
Male
Other
Your Demographics: Age
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Please Select
45+ Years
45 - 29 Years
Less than 29 Years
How often do you think Mentors and Mentees should meet in order to develop an effective relationship?
Every 2 weeks
Every 2 months
Monthly
About twice a year
Depends on the relationship or need
How do you think Mentor/Mentee partnerships should be matched?
A coordinator matches Mentees with suitable Mentors
Mentees select a potential Mentor from a list of available individuals
Mentors select potential Mentees from a list of individuals wanting to be mentored
Which topic(s) can you provide mentorship on?
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Learner Information & Preferences
Do you have someone in mind who you would like to approach to be your mentor?
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Yes
No
Possible mentor's full name
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(we will keep your request confidential)
For which topic(s) do you seek mentorship?
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100-word summary of mentorship capacity
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Preferred age of Mentor
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No preference
45+ Years
45 - 29 Years
Less than 29 Years
Would you prefer a mentor who works across disciplines?
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Yes
No
Not Necessarily
Submit
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