Nominated year level/s *

Students (Mentees) must be enrolled in a Victorian school (Year 7 - Year 12, 2020), in order to participate in the online 2020 Girledworld Workplace Mentoring Program. (This is a legal requirement for Mentee program participation.) Note: All schools will be provided with a unique URL code for access, and nominated educators are welcome to undertake the course prior to students. There is no charge for this course for Victorian schools and students.

Year 7

Year 8

Year 9

Year 10

Year 11

Year 12

Other

Number of students (Mentees) you would like to participate in the 2020 online learning program. Note: There is no limit to the number of students per participating school.

10 students

20 students

30 students

40 students

50 students

60 students

70 students

80 students

90 students

100 students

200 students

300 students

400 students

500+ students

Primary Contact Name *

Please provide contact information for the nominated school representative who will be overseeing your school's / students participation in the online Workplace Mentoring Program. NOTE: This person can be a representative from the careers, STEM, year level or executive leadership team.

First Name

Last Name

Contact Details - Same as above? *

Yes

No (please provide contact information below)

On-site Contact Name

First Name

Last Name