Be a Mentor - Priemann Fellows

Greetings!,

We thank you for taking this step of leadership and mentorship in aid of aspiring students in your professional path.

Please note that the information we are requesting will be held in the highest confidence and will only be used as information for verification, contact and a preliminary getting to know you form. Data privacy is a key principle we continue to maintain to ensure our integrity and your safety.

As well, please be informed that completing this form does not guarantee acceptance or confirmation as a Priemann Mentor. We engage a strict vetting process to ensure mentor details are authentic and are of adequate ethical and professional standing.

We look forward to your mentorship tenure and thank you for taking this step to mentor the next you.

Priemann Fellows | Fellowship for leadership

NOTE: please fill in the required information in the required sections below and a Priemann Fellow will engage you in building an extensive profile towards verification.

Personal Information

Please enter your title ( Mr., Mrs. , Dr., Prof., Rev....*

First Name*

Middle/ Other Names

Last Name / Surname*

E-mail

Phone Number*

Professional Information

Please enter a time, within the day, most convenient to receive a phone call from a Priemann Fellow*

Please enter your official profession and/or job title*

Please enter the name of the institution you official serve in, are employed in or own/ operate*

Please enter your LinkedIn profile link or url

Please upload a Curriculum Vitae (CV)/ Recommendations/ Attestation Letter to be included in your application.*

Professional Information

Would you like to start your own business in your chosen profession or occupation? ( Please enter 'Y' for Yes, 'N' for No, 'U' for Uncertain)

Would you be willing to mentor a new Start-Up or Micro- business venture with young aspiring professionals in training.

I certify that the information provided above is true and complete to the best of my knowledge. I am aware that this self declaration statement is subject to review and verification and if such information has been falsified I may be terminated from the Priemann Fellows Mentorship Program for fraud and/or perjury. (NB. Please note that by selecting the checkbook, it is considered an assignation and acceptance of the declaration and the consequences of falsified information.)

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