Registration Form for Mentors

Registration Steps:

(1) Fill out the online registration form and click to send it to CyberMentor.
(2) You will receive a confirmation email from CyberMentor upon receipt of your registration. If you do not receive an email (check your spam folder as well), please contact programm@cybermentor.de. To complete your registration for the next round, please send us a copy of your driver's license or a written confirmation from your employer or a copy of your student ID along with your enrollment certificate by mail or by email as proof of identity.

Once all registration documents have been received, CyberMentor will inform you via email with all the details about the start of the round.

Create an account

First name:*

Last name:*

E-mail address:*

Repeat email address:*

Terms of Participation

By registering, you agree to the following:

1.	I will exchange ideas with my mentee and my CyberMINT community partners for the duration of the program, which is one year.
2.	I will take at least 30 minutes per week to exchange ideas with my mentee and my CyberMINT community partners.
3.	During my participation, I will regularly take part in surveys conducted as part of the accompanying research for program improvement and for related research on mentoring. I agree to be invited to further surveys to examine the long-term effectiveness of the program and mentoring even after my participation in the program has ended.
4.	By participating, I also agree that project contributions I have edited and made available on the CyberMentor platform may be used by CyberMentor in pseudonymized form for publicity purposes (on advertising materials and online).
5.	I send a copy of my driver's license or a written confirmation from my employer or a copy of my student ID card along with my enrollment certificate by mail or by email as proof of identity to the address below. This is done in accordance with the general Terms of Use.
	Some of the students participate in the CyberMentor Plus program, in which the mentees receive additional support from a STEM teacher at their school in addition to their online mentoring. The teachers run weekly STEM clubs specifically for CyberMentor Plus mentees, where they discuss the mentoring and carry out projects together. During the CyberMentor year, you will exchange ideas with the teacher a total of four times, e.g., via the digital exchange platform which connects mentors and teachers. This creates synergy effects that benefit both the STEM club and the mentoring program. Further information is available here.
	For mentors whose mentees participate in CyberMentor Plus:
6.	During the CyberMentor year, I will exchange about the mentoring with my mentee's teacher quarterly. For this purpose, my profile will be linked to a separate area of the mentoring platform for STEM club leaders and mentors, to which I will then be granted access.

I have read and agree to the Terms of Participation, the Terms of Use, and the Privacy Policy.*

1. Personal Information

Title:

Additional address field:

Street with number:*

Postal code:*

Location:*

Federal state:*

Country:*

Nationality:

Phone (format: +49xxxx, including the "+" sign and the country code), you will then receive an SMS at the start of the round:*

Day of birth (DD):*

Month of birth (MM):*

Year of birth (YYYY):*

Marital status:

Do you have children?

Employer / current university (name, location):*

Employer / current university (name, location) - please enter new if your employer/university is not in the selection list:

2. Education / Vocational training / Professional background

Subject(s) of study / vocational training:

University / Vocational training provider:

Study / training at: University
University of Applied Sciences
Technical college
Dual vocational training
Dual university

Qualification time (in years) in the STEM field:

Studies:

Doctorate:

Habilitation:

Professional activity (without doctorate and habilitation period):

Vocational training:

Further professional qualification:

Highest educational qualification:

University entrance qualification

Bachelor's degree

Master's degree

Diploma

Magister's degree

State examination

Doctorate

Habilitation

Master craftsman

Technician

Vocational training

Other highest educational qualification:

Career level: Student
Trainee
Working student
PhD student
Postdoc
Self-employed
Habilitand
Professor
Employee
Team/group leader
Head of department
Managing director
Retired

3. Your job

Which of the following key points apply most closely to your job?

Research

Teaching

Public service

Private sector

Laboratory

Administration

Freelancer

Nonprofit

Other key points that describe your job:

Please describe in your own words what you do for a living:

4. How closely do you relate to the following STEM fields?

Mathematics:

Not at all * Very strong

Informatics:

Not at all * Very strong

Biology:

Not at all * Very strong

Chemistry:

Not at all * Very strong

Physics:

Not at all * Very strong

Engineering:

Not at all * Very strong

Other STEM area:

Further STEM area to which you assign yourself:

Not at all Very strong

5. STEM experience of the future mentee

In the following lines, you will find two opposing statements on the previous STEM experience of your future mentee. Please indicate which level of experience you would like your mentee to have. Select one circle per line accordingly. We will endeavour to take your information into account when assigning the mentoring pairs.

I could imagine mentoring a student who thinks STEM subjects are okay, but they are not her absolute favourite subjects.* I could imagine mentoring a student who counts STEM subjects among her absolute favorite subjects.

I could imagine mentoring a student who only deals with STEM subjects relatively rarely in her free time.* I could imagine mentoring a student who counts STEM as one of her absolute favourite things to do in her free time.

I could imagine mentoring a student who would like to get a taste of the STEM field for the first time at CyberMentor.* I could imagine mentoring a student who would like to engage more intensively with careers and topics from the STEM field at CyberMentor.

6. Have you ever taken part in a mentoring programme? If so, which one(s)?

I have already participated as a mentee in...

CyberMentor

another mentoring program

I have already participated as a mentor in...

CyberMentor

another mentoring program

7. How did you hear about CyberMentor?

Information from CyberMentor

Personal e-mail

Newsletter

Exhibition stand or other event

Homepage

Information from university/university of applied sciences

Mail from a student council

Mail from a study programme coordinator

Mail from an equal opportunities officer

Notice or forum post

Homepage/Intranet

Information from companies

E-mail distribution list

Newsletter

Homepage/Intranet

Media

Social media channel

namely:

Online/print magazine or journal

namely:

Advertisement

namely:

Miscellaneous

Association/initiative/network

namely:

Recommendation (former) mentee

Recommendation from (former) mentor

Friends/acquaintances/work colleagues

Other

namely:

8. Mentoring details

The mentoring year begins in mid-October. To make it as successful as possible, it is important that you make time for mentoring on a regular basis.

How regularly will you be able to make time for mentoring? daily
several times a week
weekly

In which language can you communicate with your mentee?* German only
German or English
English only

Which other language(s) do you speak?

Some of the students take part in the CyberMentor Plus program, in which the mentee is supported by a STEM teacher at the school in addition to her online mentoring. The teachers organise weekly STEM clubs specifically for CyberMentor Plus mentees, where they discuss the mentoring and carry out projects together. During the CyberMentor year, you will exchange ideas with the teacher a total of four times, for example via the digital exchange platform in which mentors and teachers are networked with each other. In this way, synergy effects are created that benefit both the STEM club and the mentoring. Further information can be found here. If your mentee is taking part in the CyberMentor Plus programme: In what way could you imagine getting involved in the school STEM club?

I could imagine ...

... to introduce myself and my work in a video call in the STEM club

... to contribute suggestions for projects from my STEM field to the STEM club

... to accompany my mentee in the realisation of an STEM club project (online)

... to accompany or advise the STEM club in the realisation of an STEM club project (online)

... to report on online mentoring in a video call in the STEM club

More ideas:

I would agree that my information on this question may be passed on to my mentee's supervising teacher.

9. Other comments:

10. Please explain why you would like to take part in CyberMentor:

Registration for mentors

We have entered your details.
A confirmation email has just been sent to the address you provided.

To complete your registration, please send a copy of your driving licence, a written confirmation from your employer or a copy of your student ID with certificate of enrolment by post or email as proof of identity to CyberMentor at: programm@cybermentor.de

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