ºÝºÝߣ

ºÝºÝߣShare a Scribd company logo

Mentorship application

•Download as DOC, PDF•
•
N
NIABI

This document is an application for a mentors program run by an agribusiness incubator. It requests information from potential mentors including their contact details, areas of expertise, work experience, education, achievements, and terms for mentoring. Mentors can choose to provide guidance in various domains including agriculture, horticulture, dairy, and biotechnology. They are asked to specify preferred functional areas of mentoring such as marketing, consulting, or business development. Details are also collected on mentors' businesses if applicable. The application collects information on mentors' availability, preferred method of mentoring, expectations for mentees, and proposed financial terms for the program.

1 of 9
Application for mentors program Agri-business incubator- ICRISAT Patancheru 502 324, Andhra Pradesh, India (NIABI Form I A) Photo (Note: You can tick multiple choices) Domain areas in which you would like to mentor Agriculture Horticulture Agri-input Agri-processing Incubation Dairy Fishery Biotechnology Agri-engineering other Specific details: ___________________________________________________________________________________________ Functional areas in which you would like to mentor Marketing Consultancy Business Fund raising (Angel/VC/Grants/Debts Quality control Legal/IPR other Specific details: ___________________________________________________________________________________________ PERSONAL DETAILS Name WORK EXPERIENCE: Please list the name of the organizations along with the designation, industry type Age have worked with. you Address Name of Designation Period Specialization Briefly describe the nature of work organization (From-To) Phone(mobile) Email ID Language proficiency Geographical areas where you want to mentor 1
BUSINESS QUALIFICATIONS: Please list any business training programs or course that you have undertaken Title of the training program Organizing Duration of the Year of completion agency training PROFESSIONAL AFFILIATION: Please list any professional organizations or committees you are FORMALwith. associated EDUCATION QUALIFICATION: Please detail here any degrees, diplomas, trade certificate that you may have. Name of the Position in the Period Briefly describe the nature of your work Degree organization Period organization Institute/ Specialization % Marks obtained Obtained (From – To) university 2
ACHIEVEMENTS: Briefly describe your achievements in your career life. 1. 2. 3. 4. 5. 3
ABOUT YOUR BUSINESS Company name Address Phone Year of operation Sole owner/Partnership/ Pvt. Ltd/ Public Ltd/ Other Industry Type Sub area of Business Describe your business: 4
What is your role in the business? Performance Snapshot: (sales, turnover, profit etc.) Financial Performance: (Please attach last two years financial statement of the business.) ABOUT MENTORING Everyone chooses to mentor for a variety of reasons. Please give us an insight as to why you want to be a mentor in this program. Do you have any previous mentoring experience? Please detail Name of the Field of Period of Achievements Briefly describe the work done during Remunerations mentoring organization mentoring Self satisfaction the program Recognition Career Advancement Social Satisfaction Business lead and networking 5
What skills do you possess that will add value to the incubatees? 1. 2. 3. 4. 5. How often do you want to mentor? Please specify the period. What days/ time you can devote for the Weekly Daily mentorship program? Monthly Quarterly Number of days in a week: Half yearly Annually Monday Tuesday Wednesday Thursday Friday Saturday 6 Sunday Any day Duration in terms of hours in a day: ____________________________________________
How do you want to provide service? Email/Chat Video conferencing Web Casting Personal visits Group activities Blogs (E.g. Seminar, workshop etc) Others please specify________________ How many free mentorship sessions you can offer? ________________________ Type of incubatees you want to work with? Established Startups Innovative Agri/Rural Woman Technology based Other Please specify___________________ How many concurrent incubatees you can work with? _________________________ What are your expectations from the mentee? 7
Terms for program Financial terms: Please specify the fee for mentorship activity as per the mode of mentorship. 1. Phone: _______________________________________________________________________ 2. Personal Visits: ________________________________________________________________ 3. Webinars/ Videoconference: _____________________________________________________ 4. Email/Chat: ___________________________________________________________________ Time Duration: Please specify the time period you want to be engaged with the mentoring activity. 1 year 2 year 3 year 4 year 5 year More than 5 year Any other terms (financial or time period terms or both) Reference Name : Designation : Phone No. : Address : Enclosures: 1. Photographs 2. Testimonials 8 3. Resume
Declaration I hereby declare that the above information is correct and I am willing to take up this assignment and will discharge all my responsibilities required thereof. Date: Signature of mentor 9

More Related Content

Mentorship application

  • 1. Application for mentors program Agri-business incubator- ICRISAT Patancheru 502 324, Andhra Pradesh, India (NIABI Form I A) Photo (Note: You can tick multiple choices) Domain areas in which you would like to mentor Agriculture Horticulture Agri-input Agri-processing Incubation Dairy Fishery Biotechnology Agri-engineering other Specific details: ___________________________________________________________________________________________ Functional areas in which you would like to mentor Marketing Consultancy Business Fund raising (Angel/VC/Grants/Debts Quality control Legal/IPR other Specific details: ___________________________________________________________________________________________ PERSONAL DETAILS Name WORK EXPERIENCE: Please list the name of the organizations along with the designation, industry type Age have worked with. you Address Name of Designation Period Specialization Briefly describe the nature of work organization (From-To) Phone(mobile) Email ID Language proficiency Geographical areas where you want to mentor 1
  • 2. BUSINESS QUALIFICATIONS: Please list any business training programs or course that you have undertaken Title of the training program Organizing Duration of the Year of completion agency training PROFESSIONAL AFFILIATION: Please list any professional organizations or committees you are FORMALwith. associated EDUCATION QUALIFICATION: Please detail here any degrees, diplomas, trade certificate that you may have. Name of the Position in the Period Briefly describe the nature of your work Degree organization Period organization Institute/ Specialization % Marks obtained Obtained (From – To) university 2
  • 3. ACHIEVEMENTS: Briefly describe your achievements in your career life. 1. 2. 3. 4. 5. 3
  • 4. ABOUT YOUR BUSINESS Company name Address Phone Year of operation Sole owner/Partnership/ Pvt. Ltd/ Public Ltd/ Other Industry Type Sub area of Business Describe your business: 4
  • 5. What is your role in the business? Performance Snapshot: (sales, turnover, profit etc.) Financial Performance: (Please attach last two years financial statement of the business.) ABOUT MENTORING Everyone chooses to mentor for a variety of reasons. Please give us an insight as to why you want to be a mentor in this program. Do you have any previous mentoring experience? Please detail Name of the Field of Period of Achievements Briefly describe the work done during Remunerations mentoring organization mentoring Self satisfaction the program Recognition Career Advancement Social Satisfaction Business lead and networking 5
  • 6. What skills do you possess that will add value to the incubatees? 1. 2. 3. 4. 5. How often do you want to mentor? Please specify the period. What days/ time you can devote for the Weekly Daily mentorship program? Monthly Quarterly Number of days in a week: Half yearly Annually Monday Tuesday Wednesday Thursday Friday Saturday 6 Sunday Any day Duration in terms of hours in a day: ____________________________________________
  • 7. How do you want to provide service? Email/Chat Video conferencing Web Casting Personal visits Group activities Blogs (E.g. Seminar, workshop etc) Others please specify________________ How many free mentorship sessions you can offer? ________________________ Type of incubatees you want to work with? Established Startups Innovative Agri/Rural Woman Technology based Other Please specify___________________ How many concurrent incubatees you can work with? _________________________ What are your expectations from the mentee? 7
  • 8. Terms for program Financial terms: Please specify the fee for mentorship activity as per the mode of mentorship. 1. Phone: _______________________________________________________________________ 2. Personal Visits: ________________________________________________________________ 3. Webinars/ Videoconference: _____________________________________________________ 4. Email/Chat: ___________________________________________________________________ Time Duration: Please specify the time period you want to be engaged with the mentoring activity. 1 year 2 year 3 year 4 year 5 year More than 5 year Any other terms (financial or time period terms or both) Reference Name : Designation : Phone No. : Address : Enclosures: 1. Photographs 2. Testimonials 8 3. Resume
  • 9. Declaration I hereby declare that the above information is correct and I am willing to take up this assignment and will discharge all my responsibilities required thereof. Date: Signature of mentor 9