Coaching/Mentorship Registration Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastGenderMaleFemaleEmail *Telephone Number: What is the key objective of your coaching or mentoring request?What do you do?StudentEmployeeManagerBusiness OwnerWhat is your mentorship needs? (Tick what applies)Understanding my current career aspirations and challengesSharing my life story with a professional mentor.Deepen understanding of my life story through reflective practiceUncovering my unique Qualities, conpetences and AbilitiesSee career possibilities, explore my abilities and take action on emerging career opportunitiesDrafting my Career Path and navigating my career planGet career guidance, refine skills, and receive objective feedbackOther (Specify)Specify any other needTotal Number of Mentoring Hours requested (Note: A nominal fee of UGX 50,000 per hour may be charged)0-3hr. Free (Preliminary coaching/mentorship).1 hr.2 hrs.3 hrs.24 hrs. (3 days)40 hrs. (5 days)Other arrangements (specify)Family Concepts Center does not charge Tuition fees to mentor young people, but a nominal fee may be applied to meet basic mentoring preparations. Sponsors may apply to support individuals or groups of young people.Do want to receive a record of the mentoring session?YesNoTerms and Agreement *I understand and agree to the terms.In checking the box above, you agree and confirm that all the information given is true and accurate. You acknowledge that your Mentor/Coach may reach out to you to confirm your participation.Submit
