Application form for a Mentor

Formularz rejestracyjny

Name*

Name

Surname*

Surname

E-mail*

E-mail

Phone nr*

Company name

Job title

Years od service

Did you participate in previous editions?

Yes

No

Recent job position`s description (with duties)

Why do you want to be a Mentor?

What can you offer to your mentee?

What are your expectations according to your mentee?

Are you University of Wrocław`s alumni?

Yes

No

Field of study

Login*

Login

Password*

Password

Potwierdzam

I consent, within the meaning of Article 4 of the Regulation of the European Parliament and of the Council (EU) 2016/679 of 27 April 2016 on the protection of individuals with regard to the processing of personal data and on the free movement of such data and the repeal of Directive 95/46 / EC (general regulation on data protection) of 27 April 2016 (Journal of Laws EU L No. 119, p. 1) for the processing of my personal data by the University of Wrocław, pl. Uniwersytecki 1, 50-137 Wrocław, for the following purposes: related to my participation as a Mentor in mentoring program: recruitment process, correspondence with careers office, promotion of the program, evaluation of the program.

I declare that I have read the information clause

Information clause

Formularz rejestracyjny

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