Office of Student Services | The University of the West Indies at Cave Hill, Barbados

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The Office of Student Services
Tel.: (246) 417-4165/6/7 Fax: (246) 424-5348 | Email: studentservices@cavehill.uwi.edu

The University of the West Indies

Cave Hill, Barbados

Tel: (246) 417-4000 | Fax: (246) 425-1327

First Name:
Last Name:
Gender:	Male Female
Email:
Home Phone:
Organization:
Position:
Profession:
Work Address:
Work Phone:
Work Fax:
Prefered Contact Method:	Telephone (H) Telephone (W) Mobile Email Fax Mail
Preferred Contact Time:	Early Morning (6am - 9am) Late Morning (10am - 12pm) Evening (1pm - 4pm) Late Evening (6pm - 9pm)
Company Website:
Alumni Affiliations :
Professional Association Affiliations:
Why did you volunteer:
Activities / exercises which you would provide to the mentee:
Values you will share with the mentee:
Non-professional experiences you will provide:
Would you be able to meet at least bi-monthly:	Yes No
If no, kindly indicate a realistic/ convenient time frame:
What other Career development services would you be interested in?:	Guest Speaking Job Shadowing Information Interviewing Internships Career Fairs Networking Events Student Short-term Consultancies
Length of participation:	1 year 2 years 3 years 4 years 5 years indefinitely To assist with our planning, kindly indicate the length of time you are likely to engage in this program by selecting one of the options above
Additional Information:	Is there another professional who may be interested in engaging in the Mentorship Program? If so, please share their details above or feel free to share our contact information with them.