MEA National Conference

MEA / Business Events Australia Mentor Program
APPLICATION FORM

This form is required by the deadline of 5.00pm Thursday 31 July 2008

Title:
First Name:
Last Name:
Post nominals:
Company:
Position:
Years in role:
Address:
Telephone:
Fax:
Email:
Special Requirements (dietary/physical):

I wish to apply for:	Mentor	Mentee
Reason for applying to be a Mentor or Mentee i.e. What skills are you looking to offer or develop?

Have you been a Mentor or Mentee Previously?	Yes	No
If so please provide details:

Area of interest:	Corporate Governance	Marketing	Sales
	Human Resources	Finance	Operations
	Business Management	Research

Other (please specify):

Qualifications & Achievements (if applicable):

Membership of other associations (if applicable):


Attachments Please attach a short CV (no more than 1 x A4 page) Please attach a recent photograph (size no bigger than 2mb) Declaration: Should I be selected to participate in the MEA / Business Events Australia Mentor Program I confirm I am available to attend the training program on Thursday 21 August 2008. I agree to meet with the allocated Mentor / Mentee 4 times during the period August to November 2008 at agreed times and venues I agree to be contacted on a regular basis by the MEA National Training Manager or MEA Manager as appropriate regarding the mentor program I agree to have my involvement in the program published by MEA and Business Events Australia

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