DATE-TIMEDate(s) - Monday, 03/06/2024
Category(ies)
Name *
Email *
Address *
City/Town *
State/County *
Zip/Post Code *
Phone (mobile) *
Phone (Other)
Membership Number
Membership Application ID
What program are you applying to join? Select ... WA QLD VIC NSW SA Distance
Would you consider joining the Distance Program if a better pairing (experience/industry sector) could be found? Yes No
Gender Male Female Prefer not to disclose
What is your preference if any a male or female mentor? Female mentor Male mentor No preference
Have you been a mentee before in the AIG Mentoring Program? Yes No
Which of the following best describes your current situation? Mature Geoscientist (>5 years) Early career (0-5 years) MSc / PhD student BSc / Hons Student
Please give details of your two most recent positions of employment and/or voluntary experience (including current positions) if applicable. Any positions related to geoscience should be listed.
Position 1
Employer
Dates of employment
Description of role
Position 2
Please list your academic qualifications (if studying, please provide expected completion date):
Course 1
Course Name *
University *
Completion date *
Course 2
Course Name
University
Completion date
INTEREST AREAS/CAREER PATH
What is your primary area of interest?
Do you have secondary areas of interest?
What are your current thoughts/plans regarding your career in the next five years?
What specific experience/areas of interest would you like your mentor to have?
What do you hope to gain from participating in the mentoring program?
What skill are you most interested to enhance and/or develop? Communication Resume writing Mental Health Time management Others
Others, please specify
PERSONALITY
When asked a question do you prefer to: Talk through the issues with your questioner and answer on the spot Go away and think about it before giving an answer
How do you rank the prospect of speaking in public: **(Terrifying) 1 2 3 4 5 (Exhilarating)** Select ... 1 2 3 4 5
In a discussion on something you feel strongly about, do you usually: Select ... offer an opinion Wait to be asked before expressing an opinion Avoid offering an opinion Change the subject Find an excuse to leave
In a discussion on something in which you have little interest in, do you usually: Select ... offer an opinion Wait to be asked before expressing an opinion Avoid offering an opinion Change the subject Find an excuse to leave
Where would you rank yourself on the extrovert-introvert scale: **(Introvert) 1 2 3 4 5 (Extrovert)** Select ... 1 2 3 4 5
You enjoy vibrant social events with lots of people: **(Agree 1 2 3 4 5 Disagree)** Select ... 1 2 3 4 5
You often think about what you should have said in a conversation long after it has taken place: **(Agree 1 2 3 4 5 Disagree)** Select ... 1 2 3 4 5
You often rely on other people to be the ones to start a conversation and keep it going:**(Agree 1 2 3 4 5 Disagree)** Select ... 1 2 3 4 5
You rarely worry if you made a good impression on someone you met:**(Agree 1 2 3 4 5 Disagree)** Select ... 1 2 3 4 5
You are more of a detail-oriented than big picture person: **(Agree 1 2 3 4 5 Disagree)** Select ... 1 2 3 4 5
