ICAP

Mentor Programme Application Form

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Name*
First Last
Business name*
Email address*
Business location*
Channel IslandsEast MidlandsEast of EnglandGreater LondonNorth EastNorth WestNorthern IrelandScotlandSouth EastSouth WestWalesWest MidlandsYorkshire and HumberOther
Business set-up*
IndependentFranchiseeFranchisorNot for profitOther
No of employees (including yourself)*
Not applicable12 - 56 - 1011 - 2021 - 4041 - 6061 - 100101 - 249250+
Length of time running your business*
Not applicableLess than one year1 - 4 years5 - 9 years10 - 14 years15 - 20 years21 - 30 yearsOver 30 years
What services do you offer? (tick all that apply)*
- Before/After-school clubs
- Birthday parties
- Events
- Holiday activity camps/clubs
- In-curricular school provision
- Nursery sessions
- Online teaching
- Private tutoring/support
- Term-time public/community classes
- Weekend clubs
- Other
- Not applicable
What age groups does your business cater for? (tick all that apply)*
- Babies (up to 12 months)
- Toddlers/Preschoolers (1 - 4 years)
- Primary school aged children (5 - 11 years)
- Early teens (12 - 15 years)
- Late teens (16 years +)
- Other
- Not applicable

Are you applying to be a mentee or a mentor?*
MenteeMentorBoth
Please briefly describe your career and business background so we can best match your skillset/experience to a suitable mentee?*
It will be at your discretion to organise how frequently you call/meet up, although a good starting point may be once a month. How many mentees do you have time to support?*
12345
Please briefly describe your career background so we can best match your skillset/experience to a suitable mentee? Please also describe your current business challenges for us to match you with a suitable mentor?*
Please briefly describe your current business challenges and what support you would most like from a mentor?*

Consent*
I agree to the privacy policy (https://institutecap.co.uk/privacy)
The information provided by you in this application will be used for purposes relating to the mentor programme. Any personal data will be stored securely on our server for internal use only and will not be shared with any third parties.