Men's Mentoring Programme

The Jesus House Men’s Mentoring Programme is a voluntary scheme for over 18s that involves Men coming alongside each other, to do life together, with the aim of helping Mentees become godly men who discover and maximize their God-given potential in every sphere of life. As we commence this next semester, we are really looking forward to what promises to be a memorable journey of growth and development as we build meaningful mentoring relationships and equip ourselves to become the Men we were created to be.

Please note that the Mentoring semester consists of 2 blocks, as follows:
Group Mentoring sessions over 7-weekly sessions
And Paired mentoring (One-to-One mentoring) for a 6 month period.

Question Title

* 1. Contact Information

Name

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

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* 2. Date of Birth

Date / Time

Date

Question Title

* 3. Marital Status

Single

Married

Divorced

Widowed

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* 4. Do you attend church?

Yes

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* 5. If Yes, what church do you attend?

Question Title

* 6. Mentee Readiness Assessment

Complete this assessment to determine your readiness to participate in a mentoring partnership. This assessment does not include scoring; rather, it includes questions to help you think about yourself and your readiness.

	Yes	No
Are you willing to invest time, energy and effort to a mentoring partnership?	Are you willing to invest time, energy and effort to a mentoring partnership? Yes	Are you willing to invest time, energy and effort to a mentoring partnership? No
Are you open to receiving feedback?	Are you open to receiving feedback? Yes	Are you open to receiving feedback? No
Are you a willing listener?	Are you a willing listener? Yes	Are you a willing listener? No
Are you willing to try new ideas and to challenge yourself?	Are you willing to try new ideas and to challenge yourself? Yes	Are you willing to try new ideas and to challenge yourself? No
Do you believe that mentoring is a useful way to develop yourself?	Do you believe that mentoring is a useful way to develop yourself? Yes	Do you believe that mentoring is a useful way to develop yourself? No

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* 7. Do you currently have a Mentor?

Yes

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* 8. At the end of the 7 week programme, would you like to be assigned a Mentor?

Yes

Not Sure

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* 9. Do you have any dietary requirements

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* 10. Consent

	Yes	No
Please contact me to keep me up to date with the Men's Mentoring Programme. This may include opportunities to support the programme , access to messages and information about our events. I understand I can unsubscribe any time from receiving these emails.	Please contact me to keep me up to date with the Men's Mentoring Programme. This may include opportunities to support the programme , access to messages and information about our events. I understand I can unsubscribe any time from receiving these emails. Yes	Please contact me to keep me up to date with the Men's Mentoring Programme. This may include opportunities to support the programme , access to messages and information about our events. I understand I can unsubscribe any time from receiving these emails. No
If you consent to us contacting you for this purpose, please tick the box to indicate you consent to your personal data being processed as detailed in our Privacy Notice (http://www.jesushouse.org.uk/privacy)	If you consent to us contacting you for this purpose, please tick the box to indicate you consent to your personal data being processed as detailed in our Privacy Notice (http://www.jesushouse.org.uk/privacy) Yes	If you consent to us contacting you for this purpose, please tick the box to indicate you consent to your personal data being processed as detailed in our Privacy Notice (http://www.jesushouse.org.uk/privacy) No
I grant permission to the Men's Mentoring Programme to use photographs/videos taken of me in publications to promote the programme.	I grant permission to the Men's Mentoring Programme to use photographs/videos taken of me in publications to promote the programme. Yes	I grant permission to the Men's Mentoring Programme to use photographs/videos taken of me in publications to promote the programme. No

Question Title

* 11. Here at Jesus House we take your privacy seriously and will only use your personal information to process your mentoring. However, from time to time we would like to contact you with details of other events, ministries, services and volunteering opportunities we provide. If you consent to us contacting you with this information, please select how you would like us to contact you (For a full statement of use of your data by Jesus House please see www.jesushouse.org.uk/privacy):

Post

Phone

Text

Men's Mentoring Programme

Question Title

* 1. Contact Information

Question Title

* 2. Date of Birth

Question Title

* 3. Marital Status

Question Title

* 4. Do you attend church?

Question Title

* 5. If Yes, what church do you attend?

Question Title

* 6. Mentee Readiness AssessmentComplete this assessment to determine your readiness to participate in a mentoring partnership. This assessment does not include scoring; rather, it includes questions to help you think about yourself and your readiness.

Question Title

* 7. Do you currently have a Mentor?

Question Title

* 8. At the end of the 7 week programme, would you like to be assigned a Mentor?

Question Title

* 9. Do you have any dietary requirements

Question Title

* 10. Consent

Question Title

* 6. Mentee Readiness Assessment

Complete this assessment to determine your readiness to participate in a mentoring partnership. This assessment does not include scoring; rather, it includes questions to help you think about yourself and your readiness.