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"INSPIRE" - PolyU’s Mentorship Programme

Mentor Registration Form

 

(* Mandatory Fields)

1. Personal Particulars
(This question is mandatory)
Title
(This question is mandatory)
Last Name
(This question is mandatory)
First Name/ Preferred Name
(This question is mandatory)

Job Title 

[For retired mentors, please enter your latest job title with a remark of “Retired”.]

(This question is mandatory)

Company 

[For retired mentors, please enter your latest company with a remark of “Retired”.]

(This question is mandatory)

Job Function

[For retired mentors, please provide information based on your previous job.]

(This question is mandatory)

Industry

[For retired mentors, please provide information based on your previous job.]

(This question is mandatory)

Years of Work Experience

(This question is mandatory)

Years of Management Experience

(This question is mandatory)
Current location:
Photo of Mentor
 Upload file
(This question is mandatory)
Are you a PolyU alumnus/alumna?
(This question is mandatory)
Year of graduation
(This question is mandatory)
Faculty/ School/ Department of graduation
(This question is mandatory)
Award
Academic Programme Title (e.g. Design, Computing, Marketing, Optometry, etc.)
(This question is mandatory)
Are you interested in organising a theme talk?
(This question is mandatory)
Please provide the topic:
(This question is mandatory)

Biography of Mentor

[Please write a few sentences about you.]

LinkedIn URL

2. Contact Information
(This question is mandatory)
Mobile
(This question is mandatory)
Email
(This question is mandatory)
Mailing Address
(This question is mandatory)
Office Tel.
Secretary’s Name
Secretary’s Email
Secretary’s Office Tel.
3. Mentorship Experience and Preference
(This question is mandatory)
Are you a mentor of any other mentorship programme(s) of PolyU?
(This question is mandatory)
Please specify:
(This question is mandatory)
Are you a mentor of any mentorship programme(s) of other education institution(s)?
(This question is mandatory)
Please specify:
(This question is mandatory)
To facilitate student integration and multicultural exchange, we may pair mentors with both local and non-local students. Please indicate your preferred communication languages with your mentees:
Other preference(s)
4. Source of Referral
(This question is mandatory)
How did you hear about us?
Please specify the referee

Please read our Personal Information Collection Statement at https://www.polyu.edu.hk/sao/personal-information-collection-statement/.

Use of Personal Data In Direct Marketing

The Hong Kong Polytechnic University would like to use your name, address, telephone number, fax number and email address to inform you of the following activities, services and facilities (collectively, “the marketing subjects”): 

  • Activities, seminars or workshops organized by us alone, jointly with other parties or by other parties;
  • Privileges, discounts and offers for services provided by us alone or jointly with other parties; and
  • Charitable, educational, social and other activities that solicit contributions, donations or participation.

We cannot use your personal data for sending information on the above marketing subjects to you unless we have received your consent. Please tick the box below to indicate your agreement for us to use your personal data to send you information on the above marketing subjects.

You may withdraw from receiving information on the marketing subjects indicated above at any time by sending an email to the Departmental Personal Data Officer at inspire.sao@polyu.edu.hk.

Disclaimer: The successful pairing of mentees is subject to the mentor’s preference and suitability of mentee candidates, in the areas of academic background, personal interests and career goals, etc.  

 

 
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