Username
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E-mail
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If you are in university please provide your university email
What city are you currently living in?
Mobile Number
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Required phone number format: ###########
Password
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Minimum length of 8 characters.
The password must have a minimum strength of Strong
Strength indicator
Repeat Password
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Role
Mentor
Mentee
Member
Parent/Guardian Full Name
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Parent/Guardian Email Address
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Ethnicity
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Black African
Black Caribbean
Black Caribbean and African
Black African and other ethnicity
Black Caribbean and other ethnicity
What year group will you be in September 2020?
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Year 11
Year 12
Year 13
Education Level
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End of Year 13
Undergraduate
Graduate
Education Level (Member)
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Year 12
Year 13
Undergraduate
Postgraduate
Full time Employment
Other
Which university are you attending/ did you attend?
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What is/was the title of your course?
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What is the name of the school you attended during GCSEs?
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What A-levels/IB subjects do you take?
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English, Maths, Further Maths
List your A Level subjects, separated by commas
What are your target/predicted A-level grades? (Leave blank if unknown) Your answer
English A*, Maths A, Further Maths A, etc
List your A Level subjects and expected grades, separated by commas
What are your achieved GCSE grades?
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English A*, Maths A, Physics A, etc
List each GCSE module and grade separated by a comma.
What type of school do you attend?
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Fee paying
Non-fee paying
What course(s) are you considering to study at university? (You may put the subject area if unsure e.g Humanities)
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What universities are you considering applying to?
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Durham, Bristol, Brunel
Input your list of universities, separated by commas
Have you been eligible for free school meals in the last 5 years?
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Yes
No
Unsure
Rather not say
Personal statement
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(Tell us about you as a person, your hobbies, interests, job etc)
What are your features that you think make you a good mentor?
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What does Black Excellence mean to you?
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What do you think you can offer to your mentee to help them excel?
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What are your long term goals?
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What do you want to gain from joining the Black Excellence Network?
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How did you hear about us?
I, the mentee confirm that I have read and agree to the terms outlined below.
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https://www.blackexcellencenetwork.net/privacy-policy/ https://www.blackexcellencenetwork.net/safeguarding-policy/
I, the mentor/member confirm that I have read and agree to the terms outlined below.
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https://www.blackexcellencenetwork.net/privacy-policy/ https://www.blackexcellencenetwork.net/safeguarding-policy/
I, the parent/guardian of the mentee confirm that I have read and agree to the terms outlined above.
*
Send these credentials via email.